Department of Radiology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, 75014, Paris, France; Université de Paris, 75006, Paris, France.
Department of Radiology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, 75014, Paris, France; Department of Radiology, Hue University of Medicine and Pharmacy, Hue University, Hue City, 530000, Viet Nam.
Eur J Radiol. 2021 May;138:109651. doi: 10.1016/j.ejrad.2021.109651. Epub 2021 Mar 11.
LI-RADS v2018 diagnostic system is used to diagnose hepatocellular carcinoma (HCC) in at risk patients. However, its applicability to HCC in non-alcoholic steatohepatitis (NASH) has not been specifically studied. The purpose of this study was to assess the applicability of LI-RADS v2018 diagnostic system for HCC in patients with NASH.
The MRI examinations of 41 patients with HCC and NASH (NASH group) were reviewed and compared to those obtained in 41 patients with HCC and virus-induced chronic liver disease (Virus group). MRI examinations of the two groups were compared for imaging presentation, LI-RADS major criteria and LI-RADS categorization. Qualitative variables were compared using Fisher exact test and quantitative variables using Mann-Whitney U test Interreader agreement was assessed using kappa statistic.
No significant differences in qualitative and quantitative variables were observed between the two groups. Most common findings in the two groups were hyperenhancement during the arterial phase and visibility on T2-weighted images (93 % vs. 98 %, P = 0.616 and 85 % vs. 88 %, P = 1.000 for NASH group and Virus group, respectively). No differences in prevalence between the two groups were found for any major LI-RADS v2018 criterion. Interreader agreement for LI-RADS categorization was strong for the NASH group (kappa = 0.802) and moderate for the virus group (kappa = 0.720). No differences were found between the two groups for LI-RADS categories (P = 0.303).
The LI-RADS v2018 diagnostic algorithm can be applied in patients with NASH.
LI-RADS v2018 诊断系统用于诊断高危患者的肝细胞癌（HCC）。然而，其在非酒精性脂肪性肝炎（NASH）中的适用性尚未得到专门研究。本研究旨在评估 LI-RADS v2018 诊断系统在 NASH 患者 HCC 中的适用性。
回顾性分析 41 例 HCC 合并 NASH 患者（NASH 组）和 41 例 HCC 合并病毒诱导的慢性肝病患者（病毒组）的 MRI 检查结果，并进行比较。比较两组的影像学表现、LI-RADS 主要标准和 LI-RADS 分类。定性变量采用 Fisher 确切检验，定量变量采用 Mann-Whitney U 检验，采用 Kappa 统计评估观察者间一致性。
两组间定性和定量变量无显著差异。两组最常见的发现是动脉期强化和 T2 加权图像上可见（93%对 98%，P=0.616 和 85%对 88%，NASH 组和病毒组分别为 P=1.000）。两组任何主要 LI-RADS v2018 标准的患病率均无差异。NASH 组 LI-RADS 分类的观察者间一致性较强（kappa=0.802），病毒组的观察者间一致性为中度（kappa=0.720）。两组 LI-RADS 分类之间无差异（P=0.303）。
LI-RADS v2018 诊断算法可应用于 NASH 患者。
