摘要
目的探讨基于钆塞酸二钠(Gd-EOB-DTPA)增强MRI采用2018版肝脏报告及影像数据系统(LI-RADS)在高危人群中诊断肝细胞癌(HCC)的效能.方法回顾性分析四川大学华西医院2015年7月至2018年9月,行Gd-EOB-DTPA增强MRI并于1个月内进行肝切除术的130例肝硬化高危结节患者(134个局灶性肝脏病灶).由2名放射科医师进行独立盲法阅片,根据2018版LI-RADS评估每个病灶的主要征象、辅助征象及LI-RADS分级,以术后病理结果为金标准评估2名医师诊断的一致性(Kappa检验)及效能.结果2名医师间LI-RADS分类的Kappa值为0.628(95%可信区间0.565~0.691),一致性良好.LR-5作为诊断标准,医师1根据2018版LI-RADS诊断HCC的灵敏度、特异度、约登指数和准确率分别为80.4%(78/97)、75.7%(28/37)、0.5608和79.1%(106/134),医师2分别为87.6%(85/97)、73.0%(27/37)、0.6059和83.6%(112/136).LR-4+LR-5作为诊断标准,医师1根据2018版LI-RADS诊断HCC的灵敏度、特异度、约登指数和准确率分别为91.8%(85/97)、67.6%(25/37)、0.5931和82.1%(110/134),医师2分别为96.9%(94/97)、67.6%(25/37)、0.6446和88.8%(119/134).结论基于Gd-EOB-DTPA增强MRI,2018版LI-RADS在高危人群中诊断HCC具有较高的灵敏度及准确率.
Objective To explore the diagnostic performance of the most recent 2018 version of liver reporting and data system(LI-RADS)on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced MRI to diagnose hepatocellular carcinoma(HCC)in high-risk patients.Methods From July 2015 to September 2018,130 consecutive high-risk patients with 134 focal liver lesions were retrospectively enrolled in our center and underwent Gd-EOB-DTPA-enhanced MRI and subsequent hepatectomy within 1 month.Two independent radiologists blindly reviewed the preoperative MR images of all patients,and determined the presence of major features,ancillary features and the LI-RADS categories according to the version 2018 LI-RADS of each liver observation.The sensitivity,specificity,positive predictive value,negative predictive value,Youden index and accuracy of the 2018 version of LI-RADS were evaluated with postoperative histopathological results as references.The inter-observer agreement between the two radiologists was tested by Kappa analysis.Results The Kappa value of the LI-RADS categories between two radiologists was 0.628(95%CI:0.565 to 0.691).The sensitivity,specificity,Youden index values and accuracy of LR-5 by the two reviewers were 80.4%(78/97),87.6%(85/97);75.7%(28/37),73.0%(27/37);0.5608,0.6059;79.1%(106/134),83.6%(112/136),respectively.These measures of LR-4+LR-5 were 91.8%(85/97),96.9%(94/97);67.6%(25/37),67.6%(25/37);0.6059,0.6446;82.1%(110/134),88.8%(119/134),respectively.Conclusion Version 2018 LI-RADS demonstrated high sensitivity and accuracy to diagnosis HCC in high-risk patients on Gd-EOB-DTPA enhanced MRI.
作者
杨采薇
蒋涵羽
宋彬
陈婕
Yang Caiwei;Jiang Hanyu;Song Bin;Chen Jie(Department of Radiology,West China Hospital,Sichuan University,Chengdu 610041,China)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2019年第12期1060-1064,共5页
Chinese Journal of Radiology
基金
国家自然科学基金(81771797)。
关键词
肝肿瘤
磁共振成像
造影剂
肝脏影像报告及数据系统
Liver neoplasms
Magnetic resonance imaging
Media contrast
Liver imaging reporting and data system
