本研究旨在评估肝细胞癌（HCC）生物学特征对高危患者肝脏成像报告和数据系统（LI-RADS）v2017超声造影（CEUS）类别的影响，并比较不同患者的结果2017年6月至2020年12月期间，前瞻性收集了中国多个中心的肝结节标准化CEUS数据。我们对前瞻性收集的经病理诊断的直径不超过 5 cm 的 HCC 数据进行了回顾性分析。 LI-RADS 类别是在彻底评估 CEUS 特征后分配的。然后，比较不同分化、Ki-67 和微血管侵犯 (MVI) 状态的 CEUS LI-RADS 类别和主要特征。进一步分析不同 LI-RADS 类别的无复发生存率 (RFS) 差异。共纳入 293 名患者的 293 个 HCC 结节。这项研究揭示了 HCC 的 CEUS LI-RADS 类别在分化（p < 0.001）和 Ki-67 水平（p = 0.01）之间存在显着差异，并且低分化（LR-M 中为 32.7%，LR-5 中为 12%）和 LR-4 中的 6.2%）（p < 0.001）和高水平的 Ki-67（中值 30%）更常被分类为 LR-M 类别，而分化良好（LR-4 中为 37.5%，15.1） LR-5 中的 %，LR-M 中的 11.5%）和低水平的 Ki-67（中值 11%）更常被归入 LR-4 类别。 MVI 和 CEUS LI-RADS 类别之间没有发现显着差异 (p > 0.05)。中位随访时间为 23 个月，分配到不同 CEUS LI-RADS 类别的 HCC 切除后 RFS 没有显着差异。HCC 的生物学特征，包括分化和 Ki-67 表达水平，可能影响 CEUS 和影响 CEUS LI-RADS 类别。不同 CEUS LI-RADS 类别的 HCC 切除后 RFS 没有显着差异。作者版权所有 © 2023。由巴塞尔 S. Karger AG 出版。

The present study aimed to evaluate the influence of biological characteristics of hepatocellular carcinoma (HCC) on the Liver Imaging Reporting and Data System (LI-RADS) v2017 category of contrast-enhanced ultrasound (CEUS) in patients with high risk and compare the outcomes among different categories after radical resection.Between June 2017 and December 2020, standardized CEUS data of liver nodules were prospectively collected from multiple centers across China. We conducted a retrospective analysis of the prospectively collected data on HCCs measuring no more than 5 cm, as diagnosed by pathology. LI-RADS categories were assigned after thorough evaluation of CEUS features. Then, CEUS LI-RADS categories and major features were compared in different differentiation, Ki-67, and microvascular invasion (MVI) statuses. Differences in recurrence-free survival (RFS) among different LI-RADS categories were further analyzed.A total of 293 HCC nodules in 293 patients were included. This study revealed significant differences in the CEUS LI-RADS category of HCCs among differentiation (p < 0.001) and levels of Ki-67 (p = 0.01) and that poor differentiation (32.7% in LR-M, 12% in LR-5, and 6.2% in LR-4) (p < 0.001) and high level of Ki-67 (median value 30%) were more frequently classified into the LR-M category, whereas well differentiation (37.5% in LR-4, 15.1% in LR-5, and 11.5% in LR-M) and low levels of Ki-67 (median value 11%) were more frequently classified into the LR-4 category. No significant differences were found between MVI and CEUS LI-RADS categories (p > 0.05). With a median follow-up of 23 months, HCCs assigned to different CEUS LI-RADS classes showed no significant differences in RFS after resection.Biological characteristics of HCC, including differentiation and level of Ki-67 expression, could influence major features of CEUS and impact the CEUS LI-RADS category. HCCs in different CEUS LI-RADS categories showed no significant differences in RFS after resection.Copyright © 2023 by The Author(s). Published by S. Karger AG, Basel.