Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-gu, Seoul, 06351, Republic of Korea.
Eur Radiol. 2017 Oct;27(10):4394-4405. doi: 10.1007/s00330-017-4804-1. Epub 2017 Apr 3.
To assess major imaging features of Liver Imaging Reporting and Data System (LI-RADS) on contrast-enhanced CT and gadoxetic acid-enhanced MRI and to estimate whether the combination of signal intensity favouring HCC on hepatobiliary phase (HBP) and diffusion-weighted images (DWI) can act as a major feature in LI-RADS.
Four hundred twenty one patients with 445 observations were included. Major features of LI-RADS on CT and MRI as well as HBP and DWI features were assessed. Diagnostic performances of LR-5 according to LI-RADS v2014 and modified LI-RADS which incorporate combination of HBP and DWI were assessed. Pairwise comparisons of the receiver operating characteristic (ROC) curves were performed.
For HCCs, capsule appearance had the highest rate of discordance between CT and MRI (32.7%), followed by washout appearance (22.2%). Specificity (75%) of LR-5 of LI-RADS v2014 was lower than that (77.1-79.2%) of modified LI-RADS. Area under the ROC curve of modified LI-RADS (0.755-0.775) was not significantly different from that of LI-RADS v 2014 (0.709) (p > 0.05).
There were substantial discordances between CT and MRI for capsule and washout appearances in hepatic observations, and combination of gadoxetic acid-enhanced MRI and DWI might be able to be incorporated as a major feature of LI-RADS.
• Major imaging features of LI-RADS showed substantial discordances on CT and MRI. • An observation may be categorized differently depending on used imaging exam. • CT and MRI should both be performed for LR-3 and LR-4 observations. • Combination of gadoxetic acid-enhanced MRI and DWI may be a major feature.
评估对比增强 CT 和钆塞酸增强 MRI 的肝脏影像报告和数据系统（LI-RADS）的主要影像学特征，并评估肝胆期（HBP）和弥散加权成像（DWI）上的信号强度是否有利于肝癌的表现是否可以作为 LI-RADS 的主要特征。
共纳入 421 例 445 个病灶患者。评估 CT 和 MRI 上的 LI-RADS 主要特征以及 HBP 和 DWI 特征。根据 LI-RADS v2014 和纳入 HBP 和 DWI 组合的改良 LI-RADS 评估 LR-5 的诊断性能。进行了 ROC 曲线的两两比较。
对于 HCC，包膜外观在 CT 和 MRI 之间的不符率最高（32.7%），其次是洗脱外观（22.2%）。LI-RADS v2014 的 LR-5 的特异性（75%）低于改良 LI-RADS（77.1%-79.2%）。改良 LI-RADS 的 ROC 曲线下面积（0.755-0.775）与 LI-RADS v2014（0.709）无显著差异（p＞0.05）。
肝脏观察中 CT 和 MRI 在包膜和洗脱外观方面存在很大差异，并且钆塞酸增强 MRI 和 DWI 的组合可能能够被纳入 LI-RADS 的主要特征。
LI-RADS 的主要影像学特征在 CT 和 MRI 上存在很大差异。
取决于所使用的成像检查，观察结果可能会分类不同。
对于 LR-3 和 LR-4 观察，应同时进行 CT 和 MRI。
钆塞酸增强 MRI 和 DWI 的组合可能是一个主要特征。
