钆贝葡胺双功能对比MRI对肝细胞癌LI-RADS定义征象的识别率分析

发布时间：2018-04-26 03:25

本文选题：肝细胞癌 + 肝硬化　；参考：《中国医学计算机成像杂志》2017年05期

【摘要】：目的:探讨2014版肝脏影像报告及数据系统(LI-RADS v2014)所定义的各种征象在钆贝葡胺(Gd-BOPTA)双功能对比一站式MR成像上的识别率。方法:2013年10月-2016年9月肝硬化患者40例入组本研究,均行肝脏Gd-BOPTA双功能对比一站式MR成像(包括多期增强、平扫、扩散加权成像、肝胆期成像),且经病理证实为HCC。由两位阅片者对MR图像进行独立盲法读片,遵循LI-RADS v2014对主要征象、次要征象进行评价,计算两者对各种征象的识别率,并通过Kappa检验来分析两者对征象识别的一致性。结果:两位阅片者对HCC病灶的动脉期高强化、廓清、包膜等3个主要征象的识别率依次分别为85.7%和90.5%、78.6%和81.0%、50.0%和52.4%,阅片者间的一致性(Kappa值)分别为0.774、0.779和0.667;对于次要征象,以HCC病灶肝胆期低信号、T2WI稍高信号、扩散受限的识别率最高,分别为83.3%和81.0%、81.0%和85.7%、90.5%和85.7%,阅片者间的一致性(Kappa值)分别为0.780、0.659和0.807,而其他次要征象识别率较低,尤其在最大径2.0cm的小HCC中部分征象未被识别。结论:肝脏Gd-BOPTA双功能对比一站式MR成像适用于肝硬化背景下HCC的LI-RADS v2014分析。
[Abstract]:Objective: to investigate the recognition rate of various signs defined by the 2014 version of liver image report and data system (LI-RADS v2014) in gadolinium meglumine Gd-BOPTA-Gd-BOPTA-one stop Mr imaging. Methods: from October 2013 to September 2016, 40 patients with liver cirrhosis were enrolled in this study. All patients underwent Gd-BOPTA duplex Mr imaging (including multiphase enhancement, plain scan, diffusion-weighted imaging, hepatobiliary phase imaging and pathologically proved HCC). Mr images were read by independent blind method by two film-readers. The main signs and secondary signs were evaluated according to LI-RADS v2014. The recognition rates of each sign were calculated, and the consistency of the two signs was analyzed by Kappa test. Results: the recognition rates of the three main signs of HCC lesions were 85.7%, 78.6%, 81.0% and 52.4%, respectively, and the consistency between the film readers were 0.7740.779 and 0.667, respectively, and those of the secondary signs were 0.7740.779 and 0.667 respectively. In HCC, hypointensity in liver and bile phase was slightly hyperintense, and diffusion-limited recognition rate was the highest (83.3% and 81.0% and 85.70.5% and 85.7%, respectively). The consistency of Kappa was 0.780 卤0.659 and 0.807, respectively, while the recognition rate of other secondary signs was lower. Especially in small HCC with maximum diameter 2.0cm, some signs were not identified. Conclusion: liver Gd-BOPTA dual function contrast Mr imaging is suitable for LI-RADS v2014 analysis of HCC in cirrhotic background.
【作者单位】：吉林市人民医院放射科;中南大学湘雅二医院放射科;
【基金】：吉林省卫生厅科研项目(No.2013Z064)~~
【分类号】：R445.2;R735.7

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