肝脏影像报告和数据系统对使用 MRI 诊断肝细胞癌的研究的影响。
Impact of the Liver Imaging Reporting and Data System on Research Studies of Diagnosing Hepatocellular Carcinoma Using MRI.
机构信息
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Department of Gastroenterology, Liver Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
出版信息
Korean J Radiol. 2022 May;23(5):529-538. doi: 10.3348/kjr.2021.0393. Epub 2022 Mar 8.
OBJECTIVE
Since its introduction in 2011, the CT/MRI diagnostic Liver Imaging Reporting and Data System (LI-RADS) has been updated in 2014, 2017, and 2018. We evaluated the impact of CT/MRI diagnostic LI-RADS on liver MRI research methodology for the diagnosis of hepatocellular carcinoma (HCC).
MATERIALS AND METHODS
The MEDLINE, EMBASE, and Cochrane databases were searched for original articles reporting the diagnostic performance of liver MRI for HCC between 2011 and 2019. The MRI techniques, image analysis methods, and diagnostic criteria for HCC used in each study were investigated. The studies were classified into three groups according to the year of publication (2011-2013, 2014-2016, and 2017-2019). We compared the percentage of studies adopting MRI techniques recommended by LI-RADS, image analysis methods in accordance with the lexicon defined in LI-RADS, and diagnostic criteria endorsed by LI-RADS. We compared the pooled sensitivity and specificity between studies that used the LI-RADS and those that did not.
RESULTS
This systematic review included 179 studies. The percentages of studies using imaging techniques recommended by LI-RADS were 77.8% for 2011-2013, 85.7% for 2014-2016, and 84.2% for 2017-2019, with no significant difference ( = 0.951). After the introduction of LI-RADS, the percentages of studies following the LI-RADS lexicon were 0.0%, 18.4%, and 56.6% in the respective periods ( < 0.001), while the percentages of studies using the LI-RADS diagnostic imaging criteria were 0.0%, 22.9%, and 60.7%, respectively ( < 0.001). Studies that did not use the LI-RADS and those that used the LI-RADS version 2018 showed no significant difference in sensitivity and specificity (86.3% vs. 77.7%, = 0.102 and 91.4% vs. 89.9%, = 0.770, respectively), with some difference in heterogeneity (I² = 94.3% vs. 86.7% in sensitivity and I² = 86.6% vs. 53.2% in specificity).
CONCLUSION
LI-RADS imparted significant changes in the image analysis methods and diagnostic criteria used in liver MRI research for the diagnosis of HCC.
目的
自 2011 年引入 CT/MRI 诊断肝脏成像报告和数据系统（LI-RADS）以来，该系统已分别在 2014 年、2017 年和 2018 年进行了更新。本研究旨在评估 CT/MRI 诊断 LI-RADS 对肝细胞癌（HCC）诊断的肝脏 MRI 研究方法学的影响。
材料与方法
在 MEDLINE、EMBASE 和 Cochrane 数据库中检索 2011 年至 2019 年间报道的肝脏 MRI 诊断 HCC 的原始研究。调查了每项研究中使用的 MRI 技术、图像分析方法和 HCC 诊断标准。根据发表年份（2011-2013 年、2014-2016 年和 2017-2019 年）将研究分为三组。我们比较了采用 LI-RADS 推荐的 MRI 技术、符合 LI-RADS 定义的词汇表的图像分析方法以及 LI-RADS 认可的诊断标准的研究比例。我们比较了使用 LI-RADS 和不使用 LI-RADS 的研究之间的汇总敏感性和特异性。
结果
本系统评价纳入了 179 项研究。2011-2013 年、2014-2016 年和 2017-2019 年采用 LI-RADS 推荐的成像技术的研究比例分别为 77.8%、85.7%和 84.2%，差异无统计学意义（ = 0.951）。LI-RADS 引入后，分别遵循 LI-RADS 词汇表的研究比例分别为 0.0%、18.4%和 56.6%（<0.001），而采用 LI-RADS 诊断成像标准的研究比例分别为 0.0%、22.9%和 60.7%（<0.001）。未使用 LI-RADS 和使用 LI-RADS 版本 2018 的研究在敏感性和特异性方面无显著差异（86.3% vs. 77.7%， = 0.102 和 91.4% vs. 89.9%， = 0.770），但异质性存在差异（敏感性的 I² = 94.3% vs. 86.7%和特异性的 I² = 86.6% vs. 53.2%）。
结论
LI-RADS 对 HCC 诊断的肝脏 MRI 研究中的图像分析方法和诊断标准产生了重大影响。
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