摘要
目的探讨2018版肝脏影像报告数据系统(LI-RADS)诊断小肝细胞癌的效能和阅片者间一致性。方法收集2017年6月—2020年7月四川省肿瘤医院符合纳入标准的115例患者(115个病灶)的CT和MRI影像资料,其中手术病理证实HCC 89例、非HCC恶性肿瘤9例,良性病灶17例。两名放射科医生盲法独立回顾性阅片,依据LI-RADS v2018分类法则,对所有病灶进行分类。两名医生的LI-RADS分类结果行Kappa一致性检验;以术后病理结果为“金标准”,计算两名医生应用LI-RADS v2018诊断HCC的敏感性、特异性、准确性,差异行McNemar检验。结果两名医生LI-RADS分类结果一致性较好,Kappa值为0.784(95%CI:0.692~0.876);以LR-5类为阳性值,两名医生应用LI-RADS v2018诊断HCC的敏感性、特异性及准确性分别为61.8%、96.2%、69.6%及58.4%、88.5%、65.2%,差异无统计学意义,P>0.05;以LR-5/4类为阳性值,两名医生诊断HCC的敏感性、特异性及准确性分别为78.8%、80.8%、79.1%及78.8%、65.4%、75.6%,差异无统计学意义,P>0.05。结论2018版肝脏影像影像报告数据系统诊断小肝细胞癌有中度的敏感性和较高的特异性,并具有较好的阅片者一致性。
Objective To investigate the efficiency of liver imaging report data system version 2018(LI-RADSv2108)in the diagnosis of small hepatocellular carcinoma(sHCC)and the consistency between LI-RADSv2108 and radiologists.Methods One hundred and fifteen patients admitted to our hospital from June 2017 to July 2020 were selected,including 89 HCC patients,9 non-HCC malignant tumors and 17 benign lesions.The images were analyzed retrospectively with blind evaluation by 2 radiologists,and all the lesions were classified according to standard of LI-RADSv2108.The consistency of the conclusion drawn by the 2 radiologists was analyzed by Kappa statistic.Taking the postoperative pathological results as gold standard,the sensitivity,specificity and accuracy of the diagnositic conclusions drawn by the 2 radiologists using LI-RADSv2108 were calculated.McNemar test was performed for the differences.Results The consistency of the diagnositc results between the 2 radiologists was substantial,Kappa value was 0.748(95%CI:0.692-0.876).Using LR-5 as a predictor of sHCC,the sensitivity,specificity and accuracy of the diagnositic conclusion drawn by the 2 radiologists respectively using LI-RADSv2108 were 61.8%,96.2%,69.6%and 58.4%,88.5%,65.2%,respectively,with no significant difference(P>0.05);Using LR 4/5 as a predictor of sHCC,the sensitivity,specificity and accuracy were 78.8%,80.8%,79.1%and 78.8%,65.4%,75.6%,respectively,with no significant difference(P>0.05).Conclusion LI-RSDSv2018 has moderate sensitivity and high specificity in diagnosing sHCC and the consistency between LI-RADSv2108 and radiologists is good.
作者
梁旭
刘圆圆
杨学刚
任静
LIANG Xu;LIU Yuan-yuan;YANG Xue-gang;REN Jing(Department of Radiology,Sichuan Cancer Hospital,Chengdu 610041,China)
出处
《肝脏》
2021年第10期1096-1098,1106,共4页
Chinese Hepatology
基金
四川省医学科研课题计划(Q18004)。
