LI-RADS分级标准对原发性肝癌诊断价值的初步探讨  

Application of LI-RADS Classification Criteria for Diagnosis of Primary Hepatocellular Carcinoma

作　　者：赵伟[1] 李文政[1] 易小平[1] 裴贻刚[1] 刘慧[1] 张丽青[1] 刘华平[1] 

机构地区：[1]中南大学湘雅医院放射科,长沙410008

出　　处：《临床放射学杂志》2016年第3期384-388,共5页Journal of Clinical Radiology

基　　金：湖南省自然科学基金项目(编号:13JJ6007);湖南省教育厅基金项目(编号:13CS13038)

摘　　要：目的 初步探讨LI-RADS分级标准对原发性肝癌的诊断价值。方法 搜集2014年5月至2014年10月期间术后病理证实的68例原发性肝癌患者的影像学资料（其中CT 38例,MRI 30例）,由3名影像学副教授在不知道病变的病理结果的情况下对图像资料进行评阅,按LI-RADS分级标准和非LI-RADS分级标准分为两组,分别给出诊断结果,比较两组诊断原发性肝癌的正确率并采用卡方检验。结果 当LR4、LR5类为阳性时,CT组LIRADS和非LI-RADS方法诊断HCC的诊断正确率分别为73.7%（28/38）、55.3%（21/38）;两者之间差异有统计学意义,前者高于后者（χ~2=38,P0.05）。如果将LR3类也视为阳性,则LI-RADS方法诊断HCC的正确率更高,CT组达到94.7%（36/38）,MRI组达到96.7%（29/30）,且无论CT组或MRI组LI-RADS方法诊断HCC的正确率均高于非LI-RADS方法,两者之间差异有统计学意义（CT组χ~2=38,P〈0.05;MRI组χ~2=30,P〈0.05）。LI-RADS和非LI-RADS两种方法评阅过程中出现意见不一致的概率分别为7.3%（5/68）、22.0%（15/68）,采用LI-RADS方法诊断原发性HCC,不同医生之间意见不一致的情况明显减少,Objective To investigate the value of LI-RADS classification criteria to the diagnosis of primary Hepatocel- lular Carcinoma. Methods Three associate professors, on the premise of not knowing the pathological results, reviewed68 radiographic images （CT 38 cases, M RI 30 cases） of patiens who were confirmed with primary Hepatocellular Car- cinoma by diagnostic pathology in Xiangya Hospital from May 2014 to October 2014, and gave their diagnostic results re- spectively on the basis of the LI-RADS classification criteria and the non-LI-RADS classification criteria. Then we compared the diagnostic accuracy of the two groups by using -chi-square test. Results If scores 4 and 5 were positive,in contrast-enhanced CT （CECT） group ,the accuracy rate of using LI-RADS classification criteria was higher than that of using non-LI-RADS classification criteria（73.7% （28/38） vs. 55.3% （21/38） ）and there was significant difference between the 2 groups（ X^2 = 38, P 〈0. 05 ）. While in MRI group, the accuracy rate between the 2 groups （86.7% （26/30） vs70.0% （21/30） showed no significant difference （X^2 = 30,P 〉 0.05 ）. If scores 3,4 and 5 were positive, both in CT group and MRI group , the accuracy rate of using LI-RADS classification criteria （CT94.7% （36/38）, MRI96.7% （29/30）.） was higher than that of using non-LI-RADS classification criteria, and there was significant difference between the 2 groups （CT group X^2 = 38, P 〈 0.05 ; MRI group X^2 = 30, P 〈 0.05 ） . the rate of disagreement in the two reviews was respectively 7.3% （5 of 68） and 22.0% （ 15 of 68） , and it reduced significantly when they used LI-RADS classification criteria to di- agnose primary Hepatocellular Carcinoma. There was significant difference between the 2 groups （X^2 = 5. 862, P 〈 0.05 ）. Conclusion There is higher diagnostic accuracy and diagnostic consistency to diagnose primary Hepatocellular Carcinoma by using the LI-RADS classification criteria. And it has a certain value in th

关 键 词：LI-RADS CT MRI 原发性肝癌 

分 类 号：R735.7[医药卫生—肿瘤] R730.44[医药卫生—临床医学] R445.2