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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LIRADS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。
Objective: To evaluate the value of CT and MRI in the diagnosis of hepatocellular carcinoma (HCC) based on LI-RADS 2014 scoring system. Methods: This study was a multicenter, intra-individual controlled study of 51 cases (54 HCC lesions) pathologically confirmed cases of chronic hepatitis B with cirrhosis and HCC patients, all patients underwent CT and MRI plain and dynamic Enhanced scan (two checks less than one month apart). Two radiologists with different seniority, according to the LI-RADS standard, conducted independent blind reading on the two reading units of dynamic contrast-enhanced CT and dynamic contrast-enhanced MRI in all the patients. Each reader Wait for at least one month after reading a cell to enter the next cell. The consistency of scores between two readers was analyzed by Kappa test. Results: The CT images of 51 patients with HCC were evaluated by two readers. The LI-RADS scores were 4.13 ± 1.10 and 4.07 ± 1.13, respectively, with consistent agreement (Kappa = 0.550). On the other hand, The readers’ LIRADS scores were 4.61 ± 0.65 and 4.31 ± 0.91, respectively, with a consistent agreement (Kappa = 0.398). CONCLUSIONS: In the case of HCC lesions, the diagnostic accuracy of LI-RADS is better than that of plain-scan combined with dynamic contrast-enhanced MRI in dynamic enhancement CT.