Pereira Rita de Cassia Ribeiro, Heming Carolina Augusta Modena, Tejo Thiago Ramos, de Oliveira Thais Cristina Lima, da Silva Rita do Socorro Uchoa, Parente Daniella Braz
Universidade Federal do Acre (UFAC), Rio Branco, AC, Brazil.
Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA), Rio de Janeiro, RJ, Brazil.
Radiol Bras. 2020 Jan-Feb;53(1):14-20. doi: 10.1590/0100-3984.2018.0077.
To evaluate liver lesions, in accordance with the LI-RADS classification, using contrast-enhanced multiphase dynamic computed tomography in patients with hepatitis B, coinfected or not with hepatitis D, or with chronic hepatitis C, as well as to determine the level of agreement between radiologists.
We evaluated 38 patients with hepatitis B, coinfected or not with hepatitis D, or with chronic hepatitis C, all of whom underwent contrast-enhanced multiphase dynamic computed tomography. For each examination, two radiologists selected up to three hepatic lesions, categorizing them in accordance with the LI-RADS classification and evaluating signs of chronic liver disease and portal hypertension. To determine the level of agreement between radiologists, we calculated the kappa statistic (κ) .
Radiologist 1 and radiologist 2 selected 56 and 48 liver lesions, respectively. According to radiologist 1 and radiologist 2, respectively, 27 (71%) and 23 (61%) of the 38 patients had at least one liver lesion; 13 (34%) and 12 (32%) had a LI-RADS 5 lesion (κ = 0.821); 19 (50%) and 16 (42%) had a hypervascular lesion (κ = 0.668); and 30 (79%) and 24 (63%) had splenomegaly (κ = 0.503). Both radiologists identified chronic liver disease in 31 (82%) of the patients (κ = 1.00).
Lesions categorized as LI-RADS 5 were detected in approximately 32% of the patients, with almost perfect agreement between the radiologists. The level of agreement was substantial or moderate for the other LI-RADS categories.
使用多期动态增强计算机断层扫描，根据肝脏影像报告和数据系统（LI-RADS）分类评估乙型肝炎患者（无论是否合并丁型肝炎感染）或丙型肝炎患者的肝脏病变，并确定放射科医生之间的一致性水平。
我们评估了38例乙型肝炎患者（无论是否合并丁型肝炎感染）或丙型肝炎患者，所有患者均接受了多期动态增强计算机断层扫描。对于每次检查，两名放射科医生最多选择三个肝脏病变，根据LI-RADS分类对其进行分类，并评估慢性肝病和门静脉高压的征象。为了确定放射科医生之间的一致性水平，我们计算了kappa统计量（κ）。
放射科医生1和放射科医生2分别选择了56个和48个肝脏病变。根据放射科医生1和放射科医生2的评估，38例患者中分别有27例（71%）和23例（61%）至少有一个肝脏病变；13例（34%）和12例（32%）有LI-RADS 5类病变（κ = 0.821）；19例（50%）和16例（42%）有高血供病变（κ = 0.668）；30例（79%）和24例（63%）有脾肿大（κ = 0.503）。两名放射科医生均在31例（82%）患者中识别出慢性肝病（κ = 1.00）。
约32%的患者检测到LI-RADS 5类病变，放射科医生之间的一致性几乎完美。对于其他LI-RADS类别，一致性水平为实质性或中等。
