From the Department of Radiology, Centre Hospitalier de l'Université de Montréal, 1000 rue Saint-Denis, Montréal, QC, Canada H2X 0C2 (M.C., D.O., J.S.B., J.M.L., L.B., A.T.); Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada (M.C., A.T.); Department of Radiology, Montefiore Medical Center, Bronx, NY (V.C.); Department of Radiology, University of Ottawa, Ottawa, Ontario, Canada (A.Z.K.); Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); and Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, Calif (J.C.H., C.B.S.).
Radiographics. 2018 Nov-Dec;38(7):1973-2001. doi: 10.1148/rg.2018180052. Epub 2018 Oct 5.
The Liver Imaging Reporting and Data System (LI-RADS) standardizes performance of liver imaging in patients at risk for hepatocellular carcinoma (HCC) as well as interpretation and reporting of the results. Developed by experts in liver imaging and supported by the American College of Radiology, LI-RADS assigns to observations categories that reflect the relative probability of benignity, HCC, or other malignancy. While category assignment is based mainly on major imaging features, ancillary features may be applied to improve detection and characterization, increase confidence, or adjust LI-RADS categories. Ancillary features are classified as favoring malignancy in general, HCC in particular, or benignity. Those favoring malignancy in general or HCC in particular may be used to upgrade by a maximum of one category up to LR-4; those favoring benignity may be used to downgrade by a maximum of one category. If there are conflicting ancillary features (ie, one or more favoring malignancy and one or more favoring benignity), the category should not be adjusted. Ancillary features may be seen at diagnostic CT, MRI performed with extracellular agents, or MRI performed with hepatobiliary agents, with the exception of one ancillary feature assessed at US. This article focuses on LI-RADS version 2018 ancillary features seen at MRI. Specific topics include rules for ancillary feature application; definitions, rationale, and illustrations with clinical MRI examples; summary of evidence and diagnostic performance; pitfalls; and future directions. RSNA, 2018.
肝脏影像报告和数据系统（LI-RADS）标准化了肝细胞癌（HCC）高危患者的肝脏影像学表现、结果解读和报告。该系统由肝脏影像学专家开发，并得到美国放射学院的支持，它为观察结果分配类别，反映了良性、HCC 或其他恶性肿瘤的相对可能性。虽然类别分配主要基于主要影像学特征，但辅助特征可用于提高检测和特征描述的准确性、增加信心或调整 LI-RADS 类别。辅助特征通常分为有利于恶性肿瘤、特别是 HCC 或良性肿瘤。一般有利于恶性肿瘤或 HCC 的辅助特征最多可升级一个类别至 LR-4；一般有利于良性肿瘤的辅助特征最多可降级一个类别。如果存在相互矛盾的辅助特征（即，一个或多个有利于恶性肿瘤，一个或多个有利于良性肿瘤），则不应调整类别。辅助特征可在诊断 CT、使用细胞外造影剂的 MRI 或使用肝胆造影剂的 MRI 上看到，US 上评估的一个辅助特征除外。本文重点介绍 MRI 上的 LI-RADS 2018 年版辅助特征。具体内容包括辅助特征应用规则；定义、原理和临床 MRI 示例说明；证据和诊断性能总结；注意事项；以及未来方向。RSNA，2018 年。
