Department of Radiology, University of Washington School of Medicine, Seattle, WA.
Department of Radiology, University of Washington School of Medicine, Seattle, WA; Microsoft Research, Redmond, WA.
Curr Probl Diagn Radiol. 2022 Mar-Apr;51(2):176-180. doi: 10.1067/j.cpradiol.2021.03.016. Epub 2021 Apr 14.
The Liver Imaging Reporting and Data System (LI-RADS) has been widely applied to CT and MR liver observations in patients at high-risk for hepatocellular carcinoma (HCC). We investigated the impact of CT vs MR in upgrading LI-RADS 3 to LI-RADS 5 observations using a large cohort of high-risk patients.
We performed a retrospective, longitudinal study of CT and MR radiographic reports (June 2013 - February 2017) with an assigned LI-RADS category. A final population of 757 individual scans and 212 high-risk patients had at least one LI-RADS 3 observation. Differences in observation time to progression between modalities were determined using uni- and multivariable analysis.
Of the 212 patients with a LI-RADS 3 observation, 52 (25%) had progression to LI-RADS 5. Tp ranged from 64 - 818 days (median: 196 days). One hundred and three patients (49%) had MR and 109 patients (51%) had CT as their index study. Twenty-four patients with an MR index exam progressed to LI-RADS 5 during the follow-up interval, with progression rates of 22% (CI:13%-30%) at 1 year and 29% (CI:17%-40%) at 2 years. Twenty-eight patients with a CT index exam progressed to LI-RADS 5 during follow-up, with progression rates of 26% (CI:16%-35%) at 1 year and 31% (CI:19%-41%) at 2 years. Progression rates were not significantly different between patients whose LI-RADS 3 observation was initially diagnosed on MR vs CT (HR: 0.81, P = 0.44).
MR and CT modalities are comparable for demonstrating progression from LI-RADS 3 to 5 for high risk patients.
肝脏影像报告和数据系统（LI-RADS）已广泛应用于 CT 和 MR 对肝细胞癌（HCC）高危患者的肝脏观察。我们通过对高危患者的大量队列研究，调查了 CT 与 MR 在将 LI-RADS 3 升级为 LI-RADS 5 观察中的影响。
我们对 2013 年 6 月至 2017 年 2 月的 CT 和 MR 放射报告（具有指定的 LI-RADS 类别）进行了回顾性、纵向研究。最终有 757 个独立扫描和 212 个高危患者至少有一个 LI-RADS 3 观察。使用单变量和多变量分析确定两种方式之间观察到进展的时间差异。
在 212 例 LI-RADS 3 观察患者中，52 例（25%）进展为 LI-RADS 5。Tp 范围为 64-818 天（中位数：196 天）。103 例患者（49%）进行了 MR 检查，109 例患者（51%）进行了 CT 检查作为初始检查。在随访期间，24 例接受 MR 指数检查的患者进展为 LI-RADS 5，1 年时的进展率为 22%（CI：13%-30%），2 年时的进展率为 29%（CI：17%-40%）。在随访期间，28 例接受 CT 指数检查的患者进展为 LI-RADS 5，1 年时的进展率为 26%（CI：16%-35%），2 年时的进展率为 31%（CI：19%-41%）。LI-RADS 3 观察最初诊断为 MR 与 CT 的患者之间的进展率没有显著差异（HR：0.81，P=0.44）。
对于高危患者，MR 和 CT 两种方式在显示从 LI-RADS 3 到 5 的进展方面具有可比性。
