文章摘要
刘媛,李晨,吴明晓,罗晓捷,陈秀华,许静涌.超声造影与CT/MRI肝脏影像报告与数据系统对肝细胞癌诊断评分的一致性分析[J].中国临床保健杂志,2020,23(6):839-843.
超声造影与CT/MRI肝脏影像报告与数据系统对肝细胞癌诊断评分的一致性分析
Interobserver agreement of LI-RADS contrast with enhanced ultrasound and CT/MRI for the diagnosis of hepatocelluar carcinoma
投稿时间：2019-12-10  
DOI：10.3969/J.issn.1672-6790.2020.06.029
中文关键词: 癌,肝细胞  诊断技术和方法  超声检查  体层摄影术
英文关键词: Carcinoma,hepatocellular  Diagnostic techniques and procedures  Ultrasonography  Tomography 〖FL
基金项目:
作者单位E-mail
刘媛 北京医院,超声科,北京 100730 wumingxiao@sina.com 
李晨 北京医院,超声科,北京 100730 wumingxiao@sina.com 
吴明晓 北京医院,超声科,北京 100730 wumingxiao@sina.com 
罗晓捷 北京医院 放射科,北京 100730 wumingxiao@sina.com 
陈秀华 北京医院,超声科,北京 100730 wumingxiao@sina.com 
许静涌 北京医院普外科 国家老年医学中心 中国医学科学院老年医学研究院,北京 100730 wumingxiao@sina.com 
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中文摘要:
      目的 比较超声造影(CEUS)和CT/MRI检查中利用肝脏影像报告与数据系统(LI-RADS)诊断肝细胞癌(HCC)的临床价值以及不同医师之间的一致性。方法 回顾性分析具有疑诊HCC肝局灶性病变35例患者(共47个病灶)病历资料,均行超声造影以及增强CT/MRI检查,每例患者均接受超声组2位和CT/MRI组2位不同年资医师对CEUS以及CT/MRI图像进行独立盲法阅片并按照相应LI-RADS标准对病灶进行分类,应用Kappa检验比较同一组2名医师组内诊断的一致性,以病理诊断为金标准,计算2名高年资医师利用CEUS及CT/MRI对HCC的诊断符合率,应用χ2检验比较其差异有无统计学意义。结果 超声组和CT/MRI组不同医师利用CEUS-LI-RADS及CT/MRI-LI-RADS对病灶评分的一致性均为中等,Kappa值分别为0.481、0.467。将LI-RADS分类LR-4和LR-5类归为阳性,超声组和CT/MRI组2名高年资医师利用CEUS及CT/MRI对HCC的诊断符合率分别为80.9%(38/47)、89.4%(42/47),差异无统计学意义(P=0.240)。结论 超声组和CT/MRI组不同年资医师利用CEUS-LI-RADS与CT/MRI-LI-RADS对病灶的诊断评分一致性接近,对HCC的诊断符合率较高。
英文摘要:
      Objective To compare the diagnosis value and interobserver agreement for CEUS-LI-RADS versus CT/MRI-LI-RADS for the diagnosis of hepatocellular carcinoma.Methods A total of 47 lesions in 35 high-risk patients were assessed retrospectively with CEUS and CT/MRI.Two independent observers reviewed CEUS and CT/MRI examinations separately,classifying lesions according to LI-RADS.Interobserver agreement was assessed with Kappa statistic.The results of 2 senior doctors were compared to histology and/or clinical diagnosis and diagnostic accordance rates for HCC were calculated.Intermodality difference was assessed with chi-square test.Results Interobserver agreement was moderate for both CEUS-LI-RADS category (Kappa=0.481) and CT/MRI-LI-RADS category (Kappa=0.467).If LR-4 and LR-5 were positive,the diagnostic accordance rates for HCC of the 2 senior doctors with CEUS and CT/MRI were 80.9% (38/47) and 89.4%(42/47).The difference was not statistically significant.Conclusion Interobserver agreements are both moderate for CEUS and CT/MRI LI-RADS category.The diagnostic accordance rate of CEUS-LI-RADS for HCC is high,but lower than CT/MRI-LI-RADS.
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