CAJ | 학술논문

目的：应用肝脏影像报告和数据管理系统(LI-RADS)评价肝细胞肝癌(HCC)的信度及效度。方法2位影像医师根据LI-RADS v2013.1对符合纳入标准的162例肝硬化及其他具有 HCC 风险的患者进行评级,计算 Kappa 值评价两者诊断一致性和稳定性,并与病理及随访结果对照,应用灵敏度、特异度、阳性预测值、阴性预测值、阳性似然比、阴性似然比及准确度评价 LI-RADS的准确性。结果经金标准证实的162例患者,包括 HCC 97例(其中含 LR37例),良性50例,其他肿瘤15例,2位影像医师间Kappa 值是0.882,P 值是0.000。LI-RADS 分级诊断 HCC 的灵敏度为100.00%,特异度为91.30%,准确度为97.06%。结论LI-RADS 在增强 CT 诊断和评价 HCC 中具有很高的一致性和稳定性；LR3诊断需慎重,其发展为 HCC 的可能性大,结合临床及实验室检查可提高分级的准确性。
목적：응용간장영상보고화수거관리계통(LI-RADS)평개간세포간암(HCC)적신도급효도。방법2위영상의사근거LI-RADS v2013.1대부합납입표준적162례간경화급기타구유 HCC 풍험적환자진행평급,계산 Kappa 치평개량자진단일치성화은정성,병여병리급수방결과대조,응용령민도、특이도、양성예측치、음성예측치、양성사연비、음성사연비급준학도평개 LI-RADS적준학성。결과경금표준증실적162례환자,포괄 HCC 97례(기중함 LR37례),량성50례,기타종류15례,2위영상의사간Kappa 치시0.882,P 치시0.000。LI-RADS 분급진단 HCC 적령민도위100.00%,특이도위91.30%,준학도위97.06%。결론LI-RADS 재증강 CT 진단화평개 HCC 중구유흔고적일치성화은정성；LR3진단수신중,기발전위 HCC 적가능성대,결합림상급실험실검사가제고분급적준학성。
Objective To evaluate the reliability and validity of hepatocellular carcinoma (HCC)using the liver imaging reporting and data system (LI-RADS).Methods By using the LI-RADS v2013.1,two radiologists evaluated 1 62 patients with cirrhosis or with a risk of HCC according to an inclusion criteria.The Kappa value was used to evaluate the consistency between two different diagnoses and was compared with pathological and follow-up results.The accuracy of the LI-RADS was assessed including sensitivi-ty,specificity,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio and accuracy rating.Results In all 1 62 patients,there were HCCs in 97 patients including 7 patients belonging to the LR3,benign diseases in 50,and other kinds of malignancy in 1 5.The Kappa value was 0.882 (P =0.000)between two observers on LI-RADS grading. The sensitivity,specificity and accuracy rating of LI-RADS grading in diagnosing HCC was 100.00%,91.30%,and 97.06%,re-spectively.Conclusion The LI-RADS has high consistency and stability in evaluation and diagnosis of HCC by enhanced CT.LR3 di-agnosis should be cautious because of a susceptible development to HCC,which can be improved through the combination of clinic and laboratory examination.