Caraiani Cosmin, Boca Bianca, Bura Vlad, Sparchez Zeno, Dong Yi, Dietrich Christoph
Department of Medical Imaging, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania.
Department of Radiology, County Clinical Emergency Hospital Cluj-Napoca, 400006 Cluj-Napoca, Romania.
Biology (Basel). 2021 May 6;10(5):412. doi: 10.3390/biology10050412.
Different LI-RADS core documents were released for CEUS and for CT/MRI. Both documents rely on major and ancillary diagnostic criteria. The present paper offers an exhaustive comparison of the two documents focusing on the similarities, but especially on the differences, complementarity, and added value of imaging techniques in classifying liver nodules in cirrhotic livers. The major diagnostic criteria are defined, and the sensitivity and specificity of each major diagnostic criteria are presented according to the literature. The existing differences between techniques in assessing the major diagnostic features can be then exploited in order to ensure a better classification and a better clinical management of liver nodules in cirrhotic livers. Ancillary features depend on the imaging technique used, and their presence can upgrade or downgrade the LI-RADS score of an observation, but only as far as LI-RADS 4. MRI is the imaging technique that provides the greatest number of ancillary features, whereas CEUS has fewer ancillary features than other imaging techniques. In the final part of the manuscript, some recommendations are made by the authors in order to guidephysicians as to when adding another imaging technique can be helpful in managing liver nodules in cirrhotic livers.
针对超声造影（CEUS）以及CT/MRI发布了不同的肝脏影像报告和数据系统（LI-RADS）核心文档。这两份文档均依赖主要和辅助诊断标准。本文对两份文档进行了详尽比较，重点关注它们的相似之处，但尤其关注在对肝硬化肝脏中的肝结节进行分类时，成像技术的差异、互补性及附加价值。明确了主要诊断标准，并根据文献列出了各主要诊断标准的敏感性和特异性。评估主要诊断特征时技术上的现有差异随后可被利用，以确保对肝硬化肝脏中的肝结节进行更好的分类和临床管理。辅助特征取决于所使用的成像技术，其存在可提高或降低某个观察结果的LI-RADS评分，但仅限于LI-RADS 4类。MRI是提供辅助特征数量最多的成像技术，而CEUS的辅助特征比其他成像技术少。在本文的最后部分，作者给出了一些建议，以指导医生在何时增加另一种成像技术有助于管理肝硬化肝脏中的肝结节。
