Differentiating malignant from benign thrombosis in hepatocellular carcinoma: contrast-enhanced ultrasound.
Background: To determine the accuracy of contrast-enhanced ultrasonography (CEUS) in differentiating malignant and benign venous thrombosis complicating hepatocellular carcinoma (HCC). Methods: Fifty patients (M:F = 41:9; age range 46-83 years) with HCC and venous thrombosis [portal vein (PV) in 45...
| Publicado en: | Abdominal Imaging Vol. 39; no. 1; pp. 153 - 162 |
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| Autores principales: | , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Springer Nature
Feb2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103810419&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103810419 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09428925 O52 jtl: Abdominal Imaging issn: 09428925 maglogo: N pubinfo: dt: Feb2014 vid: 39 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 103810419 NLM24002440 2012458391 10.1007/s00261-013-0034-4 NLM24002440 103810419 ppf: 153 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Differentiating malignant from benign thrombosis in hepatocellular carcinoma: contrast-enhanced ultrasound. aug: au: Raza, S Arsalan Jang, Hyun-Jung Kim, Tae Kyoung affil: Joint Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Avenue, Toronto, ON, M5G 2N2, Canada. sug: subj: Carcinoma, Hepatocellular Ultrasonography Portal Vein Thrombosis Ultrasonography Ultrasonography Methods Data Analysis Software Human kappa Statistic Predictive Value of Tests ROC Curve Sensitivity and Specificity ab: Background: To determine the accuracy of contrast-enhanced ultrasonography (CEUS) in differentiating malignant and benign venous thrombosis complicating hepatocellular carcinoma (HCC). Methods: Fifty patients (M:F = 41:9; age range 46-83 years) with HCC and venous thrombosis [portal vein (PV) in 45 and hepatic vein (HV) in 5] detected on CT or MR scan were evaluated with CEUS. Reference standard of malignant and benign thrombosis was based on serial clinicoradiologic follow-up (n = 43) or pathology (n = 7). Two independent, blinded readers retrospectively recorded the enhancement features of the venous thrombosis and diagnosed as benign or malignant thrombosis with a five-point confidence scale. Receiver operating characteristic (ROC) curves were calculated to determine the diagnostic performance of CEUS in differentiating malignant from benign thrombosis. Confidence level ratings were also used to calculate the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the diagnosis of malignant thrombosis. Inter-reader agreement was calculated using κ statistics in each assessed finding. Gray scale and Doppler characteristics of primary tumor and thrombosis were also assessed. Results: Of the 50 patients, 37 were malignant (33 with PV thrombosis and 4 with HV thrombosis) and 13 were benign (12 with PV thrombosis and 1 with HV thrombosis). In ROC curve analysis for differentiating malignant from benign thrombosis, Az was 0.947 (CI 0.841-0.991) for reader 1 and 0.958 (CI 0.861-0.995) for reader 2 with excellent inter-reader agreement (κ = 0.86). When the confidence level ratings of 1 or 2 were considered malignant thrombosis, the sensitivity, specificity, PPV, and NPV in differentiating malignant from benign thrombosis were 100%, 83%, 95%, and 100% for reader 1 and 100%, 92%, 97%, and 100% for reader 2. Conclusion: CEUS is useful to differentiate malignant and benign venous thrombosis associated with HCC with high diagnostic accuracy. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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