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Contrast-enhanced ultrasound Liver Imaging Reporting and Data System category M: a systematic review and meta-analysis

Ultrasonography 2022년 41권 1호 p.74 ~ 82
신재승, 이선영, 김연윤, 정용은, 최진영, 박미숙,
소속 상세정보
신재승 ( Shin Jae-Seung ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
이선영 ( Lee Sun-Young ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
김연윤 ( Kim Yeun-Yoon ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
정용은 ( Chung Yong-Eun ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
최진영 ( Choi Jin-Young ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
박미숙 ( Park Mi-Suk ) - Yonsei University College of Medicine Severance Hospital Department of Radiology

Abstract


Purpose: A meta-analysis was conducted to determine the proportion of contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System category M (LR-M) in hepatocellular carcinomas (HCCs) and non-HCC malignancies and to investigate the frequency of individual CEUS LR-M imaging features.

Methods: The MEDLINE and Embase databases were searched from January 1, 2016 to July 23, 2020 for studies reporting the proportion of CEUS LR-M in HCC and non-HCC malignancies. The meta-analytic pooled proportions of HCC and non-HCC malignancies in the CEUS LR-M category were calculated. The meta-analytic frequencies of CEUS LR-M imaging features in nonHCC malignancies were also determined. Risk of bias and applicability were evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool.

Results: Twelve studies reporting the diagnostic performance of the CEUS LR-M category were identified, as well as seven studies reporting the frequencies of individual CEUS LR-M imaging features. The pooled proportions of HCC and non-HCC malignancies in the CEUS LR-M category were 54% (95% confidence interval [CI], 44% to 65%) and 40% (95% CI, 28% to 53%), respectively. The pooled frequencies of individual CEUS LR-M imaging features in non-HCC malignancies were 30% (95% CI, 17% to 45%) for rim arterial phase hyperenhancement, 79% (95% CI, 66% to 90%) for early (<60 s) washout, and 42% (95% CI, 21% to 64%) for marked washout.

Conclusion: In total, 94% of CEUS LR-M lesions were malignancies, with HCCs representing 54% and non-HCC malignancies representing 40%. The frequencies of individual CEUS LR-M imaging features varied; early washout showed the highest frequency for non-HCC malignancies.

키워드

Diagnosis; Liver neoplasms; Microbubbles; Sensitivity and specificity; Ultrasound

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