摘要
目的：探讨肝脏影像报告和数据管理系统（LI-RADS）MRI分级诊断标准对肝细胞癌（HCC）的诊断价值。方法：回顾性分析88例肝脏病变患者的上腹部MRI资料,并根据LI-RADS分类标准对病变进行分析评估,并与临床客观诊断结果进行比较。结果：88例患者MRI共发现117个病灶,其中LI-RADS 1~5类病灶99个：1类和2类病灶25个,临床客观诊断结果均为良性（阴性预测值为100%）;3类病灶3个,其中1个为HCC（阳性预测值为33.3%）;4类病灶8个,其中5个为HCC（阳性预测值为62.5%）;63个5类病灶中61个为HCC（阳性预测值为96.8%）。受试者工作特征（ROC）曲线下面积为0.96（P〈0.001）。若将LI-RADS 1~2类病灶归为阴性,3~5类归为阳性,LI-RADS对诊断HCC的总符合率为92.9%（92/99）,敏感度为100%（67/67）,特异度为78.1%（25/32）,阳性预测值为90.5%（67/74）,阴性预测值为100%（25/25）。若将LI-RADS 3类病灶排除,1~2类病灶归为阴性,4~5类病灶归为阳性,LI-RADS对HCC的诊断符合率为94.8%（91/96）,敏感度为100%（66/66）,特异度为83.3%（25/30）,阳性预测值为93.0%（66/71）,阴性预测值为100%（25/25）。结论：LI-RADS分类标准对HCC的MRI诊断具有很好的诊断效果,有利于提高MRI诊断报告的准确性。
Objective：To investigate the diagnositic efficacy of MRI liver imaging reporting and data system（LIRADS）for the diagnosis of hepatocellular carcinoma（HCC）.Methods：88patients at high risk of HCC underwent MRI examination.All the MR images were retrospectively analyzed and the lesions were categorized into 1of 5scales according to the LI-RADS.The diagnostic results were compared with the results of clinical final diagnosis.The sensitivity,specificity,negative（NPV）and positive predictive value（PPV）,and receiver operating characteristic（ROC）curve of MRI LIRADS were then produced.Results：117lesions were detected in all 88 patients,including 99 lesions in LI-RADS category1~5.Of the 99 lesions,25lesions of category 1or 2were all benign（NPV=100%）;one of the three lesions in category 3was HCC;of the eight lesions in category 4,five were HCCs（PPV=62.5%）;among the 63 lesions in category 5,there were 61HCCs（PPV=96.8%）.The area underneath the ROC curve was 0.96 with statistic significance（P〈0.001）.If category 1and 2were considered as negative and category 3~5as positive,the accuracy,sensitivity,specificity,PPV and NPV of the MRI LI-RADS classification for the diagnosis of HCC were 92.9%,100%,78.1%,90.5% and 100% respectively.If lesions in category 3were excluded,lesions in category 1and 2lesions were considered as negative and lesions in category 4~5as positive,the accuracy,sensitivity,specificity,PPV and NPV of the LI-RADS classification for the diagnosis of HCC were 94.8%,100%,83.3%,93.0% and 100% respectively.Conclusion：LI-RADS MRI classification provides high efficacy for the diagnosis of HCC,it may be very useful to improve the accuracy of MRI reports.
出处
《放射学实践》
北大核心
2016年第4期303-306,共4页
Radiologic Practice
基金
云南省教育厅基金(2014Y169)
云南省科技厅-昆明医科大学应用基础研究联合专项基金(2014FB062
2015FB071)
关键词
肝脏影像报告和数据管理系统
肝肿瘤
肝细胞癌
磁共振成像
诊断效能
Liver imaging reporting and data system
Hepatocellular carcinoma
Magnetic resonance imaging
Diagnostic efficacy
