CT和MRI对乙肝肝硬化背景下肝细胞癌诊断评分的一致性：基于LI-RADS的多中心、个体内对照研究

目的：基于肝脏影像报告和数据系统（LI-RADS）2014版评分系统，探讨CT和 MRI对乙肝肝硬化基础上的肝细胞肝癌（HCC）的诊断价值。方法：本研究为多中心、个体内对照研究，搜集51例（54个 HCC 病灶）经病理证实的慢性乙型肝炎肝硬化合并HCC患者的病例资料，所有患者均行CT和MRI平扫及动态增强扫描（两项检查间隔时间不超过1个月）。由2位不同年资的放射科医师根据LI-RADS标准分别对所有入组病例的动态增强CT、平扫联合动态增强MRI两个阅片单元进行独立盲法读片，每位阅片者每个单元读片结束后需等待至少一个月方能进入下个读片单元。通过Kappa检验对两位阅片者间的评分一致性进行分析。结果：两位阅片者对51例 HCC 患者 CT 图像进行评价，LI-RADS评分分别为4．13±1．10和4．07±1．13，一致性中等（Kappa＝0．550）；而基于平扫联合动态增强 MRI，两位阅片者的LI-RADS评分分别为4．61±0．65和4．31±0．91，一致性一般（Kappa＝0．398）。结论：针对 HCC 病灶，使用LI-RADS进行诊断评分时，动态增强CT的阅片者间一致性较好，优于平扫联合动态增强 MRI。

Interreader agreement of multiphasic MDCT and unenhanced combined withe nhanced MR imaging:amulticenter,intra-indi-vidual study based on LI-RADS v2014

Objective:To evaluate the diagnostic value of CT and MRI for hepatocellular carcinoma (HCC)in patients with cirrhosis induced by HBV infection based on LI-RADS 2014 version.Methods:A multi-center and intra-individual study was performed in analysis of the data of 51 patients with 54 HCCs and liver cirrhosis induced by HBV confirmed by patho-logy.All patients underwent pre-contrast and contrast enhanced MDCT and MRI examination.Based on LI-RADS v2014, two radiologists analyzed the CT and MRI images respectively and independently,and the time interval between analysis of CT and MRI data was at least one month.The Kappa statistic was used to assess inter-reader agreement for CT and MRI. Results:Based on CT images,the LI-RADS category of 54 HCCs by the two radiologists was 4.13±1.10 and 4.07±1.13, there was moderate agreement between the readers (Kappa= 0.550);based on MRI images,the LI-RADS category of 54 HCCs by the two radiologists was 4.61±0.65 and 4.31±0.91 with fair agreement (Kappa= 0.398).Conclusion:Based on LI-RADS v2014,Multiphasic MDCT showed moderate inter-reader agreement for evaluation of HCCs in patients with liver cirrhosis induced by HBV infection,while unenhanced combined with contrast-enhanced MRI showed fair agreement.