LI-RADS 2018版辅助征象在CT上诊断肝细胞肝癌的价值

Value of LI-RADS v2018 auxiliary signs in diagnosing HCC on CT

目的根据CT主要征象、结合主要和辅助征象分类,分析辅助征象对肝细胞肝癌(HCC)的诊断价值。方法回顾分析2015年1月至2021年4月保定市第一医院HCC高风险患者110例、共114个病灶,其中HCC 78个、非HCC恶性肿瘤17个、良性19个。比较主要征象、结合主要与辅助征象的诊断价值。结果当LR5为预测值,主要征象与主要与辅助征象结合比较:特异度(89.7%vs.92.1%),阳性预测值(91.5%vs.93.5%)和准确性(65.8%vs.66.7%)提高,敏感度降低(57.3%vs.56.6%);当LR4/5为预测值主要征象与主要与辅助征象结合比较:敏感度(68.2%vs.70.7%)、准确性(77.2%vs.80.1%)提高,特异度降低(69.2%vs.59.1%)。辅助征象调整了8.8%(10/114)的分类。结论在CT上辅助征象可提高LI-RADS2018版的敏感度、准确度,尤其是LR-3病灶。

Objective To analyze the diagnostic value of auxiliary signs in hepatocellular carcinoma(HCC)according to the comparation of the CT classification obtained by main signs and by combining main and auxiliary signs.Methods A total of 110 patients with high-risk HCC,including 114 lesions,admitted to Baoding No.1 Hospital from January 2015 to April 2021 were retrospectively analyzed,and they were divided into HCC malignant tumors(n=78),non-HCC malignant tumors(n=17)and benign tumors(n=19).The diagnostic values obtained by main signs and by combining main and auxiliary signs were compared.Results When LR5 was the predictive value,the values obtained by main signs were higher than those by combining main and auxiliary signs in terms of specificity(89.7%vs.92.1%),positive predictive value(91.5%vs.93.5%)and accuracy(65.8%vs.66.7%),while lower in terms of sensitivity(57.3%vs.56.6%);when LR4/5 was the predictive value,the values obtained by main signs were higher than those by combining the main and auxiliary signs in terms of sensitivity(68.2%vs.70.7%)and accuracy(77.2%vs.80.1%),while lower in terms of specificity(69.2%vs.59.1%).The classification was adjusted by 8.8%(10/114)by auxiliary signs.Conclusion Auxiliary signs on CT can improve the sensitivity and accuracy of LI-RADS v2018,especially for LR-3 lesions.