基于钆塞酸二钠增强MRI在LI-RADS v2018及LI-RADS v2017诊断肝细胞癌的对比研究

目的 探讨基于钆塞酸二钠(Gd-EOB-DTPA)增强MRI采用肝脏影像报告和数据系统2018版(LI-RADS v2018)诊断肝细胞癌(HCC)的效能,并与LI-RADS v2017进行对比研究.方法 回顾性分析2017年3月至2020年5月本院行Gd-EOB-DTPA增强MRI检查有病理结果的HCC高危患者.由三...

Comparison of LI-RADS v2018 and LI-RADS v2017 in the Evaluation of Hepatocellular Carcinoma in Gadoxetate Disodium Enhanced MRI

Objective To explore the efficacy of Liver Imaging Reporting and Data System(LI-RADS) v2018 in diagnosing HCC using Gd-EOB-DTPA enhanced MRI in HCC high-risk patients and compared with LI-RADS v2017. Methods This retrospective study between March 2017 and May 2020 evaluated consecutive patients at high risk for HCC who underwent Gd-EOB-DTPA enhanced MRI and had pathological findings.MRI features were reviewed by three radiologists.Observations were categorized according to LI-RADS v2018 and LI-RADS v2017.Per-observation sensitivity and specificity of LR-5 using LI-RADS v2017 and v2018 were compared. Theintra-group correlation coefficient(ICC) method was used to evaluate the interobserver agreement. Results A total of 157 patients with 182 observations were enrolled, including 154 HCCs confirmed by results of pathologic examination.The ICC of LIRADS v2017 and LIRADS v2018 were 0.909,0.868 respectively between three radiologists.In all observations, LI-RADS v2018 provided higher sensitivity than LI-RADS v2017(53.2% vs 42.9%,P<0.001)with relatively little impairment of specificity(82.1% vs 92.9%,P=0.25).In small observations(10-19 mm),LI-RADS v2018 yielded much higher sensitivity than LI-RADS v2017(42.6% vs 8.5%,P<0.001).After using secondary features, 88.1%(37/42)of LR-3 observations were found to be upgraded to LR-4,and hepatobiliary phase hypointensity was the most frequently used secondary features. Conclusion LI-RADS v2018 has higher sensitivity for preoperative diagnosis of HCC with relatively little impairment of specificity. It has a broad prospect in clinical application.