Does a combined CT and MRI protocol enhance the diagnostic efficacy of LI-RADS in the categorization of hepatic observations? A prospective comparative study
Does a combined CT and MRI protocol enhance the diagnostic efficacy of LI-RADS in the categorization of hepatic observations? A prospective comparative study
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DOI：
10.1007/s00330-017-5232-y
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发表时间：
2018-06-01
影响因子：
5.9
通讯作者：
Abdelbary, Eman H.
中科院分区：
文献类型：
--
作者：
Basha, Mohammad Abd Alkhalik;AlAzzazy, Mohamad Zakarya;Abdelbary, Eman H.
比较CT、MRI和联合CT/MRI之间的诊断性能和一致性，参考LI-RADS分类系统对筛选超声期间在肝脏患者中检测到的肝脏观察结果进行分类。超声监测期间检测到296个肝脏观察结果的240例患者接受了肝脏CT和MRI检查、组织病理学以及临床和放射学随访。使用LI-RADS v2014，6名放射科医生独立评估观察结果，并使用CT、MRI和CT/MRI联合对每个观察结果进行LI-RADS分类。LI-RADS中CT和MRI联合的准确性更高（91.29%），敏感性（90.71%）和特异性（92.31%）比单独使用MRI或CT对肝细胞癌（HCC）的诊断准确; MRI的准确性、敏感性和特异性分别为85.37%、86.34%和83.65%，CT的准确性、敏感性和特异性分别为67.6%、54.10%和91.35%。CT、MRI和CT/MRI联合诊断的LI-RADS评分组内一致性极好（kappa=0.9624（95%CI：0.9318-0.9806）），CT和MRI具有互补性。结合CT/MRI能够更精确地确定肝脏观察结果的LI-RADS类别;然而，由于费用和精确度的微小增加，该组合方法应仅在疑似HCC的情况下使用。MRI和联合CT/MRI。a Euro cent MRI产生更高的准确性和灵敏度，而CT产生更高的特异性。a Euro cent联合CT和MRI改进LIRADS分类报告。a Euro cent考虑到额外的成本，联合方法可能仅限于具有挑战性的病例。
To compare diagnostic performance and agreement between CT, MRI and combined CT/MRI in reference to LI-RADS classification system to categorize hepatic observations detected in hepatic patients during screening ultrasound.240 patients with 296 liver observations detected during ultrasound surveillance underwent hepatic CT and MRI examinations, histopathology, and clinical and radiological follow-up. Using LI-RADS v2014, six radiologists evaluated the observations independently and assigned a LI-RADS category to each observation using CT, MRI and combined CT/MRI.Combined CT and MRI in LI-RADS yielded better accuracy (91.29 %), sensitivity (90.71 %) and specificity (92.31 %) for hepatocellular carcinoma (HCC) diagnosis than using MRI or CT alone; accuracy, sensitivity and specificity decreased to 85.37 %, 86.34 %, and 83.65 %, respectively, for MRI and 67.6 %, 54.10 % and 91.35 %, respectively, for CT. The intraclass agreement of the LI-RADS scores between CT, MRI and combined CT/MRI was excellent (kappa=0.9624 (95 % CI: 0.9318-0.9806)).CT and MRI are complementary to each other. Combined CT/MRI enabled a more precise determination of LI-RADS category of hepatic observations; however, due to the expense and minor increase in accuracy, the combined methodology should only be utilized in cases of suspected HCC.aEuro cent Hepatic observation may be categorized differently depending on the imaging modality used.aEuro cent We compared LI-RADS categorization between CT, MRI and combined CT/MRI.aEuro cent MRI produces higher accuracy and sensitivity, while CT produces higher specificity.aEuro cent Combining CT and MRI improves LIRADS categorization reports.aEuro cent Considering additional cost, combined methodology could be restricted to challenging cases.