肝脏影像报告和数据管理系统在肝细胞癌诊断中的应用价值

Diagnostic value of liver imaging reporting and data system on hepatocellular carcinoma

  • 摘要: 为了规范和统一CT和MRI检查在报告和诊断可能为肝细胞癌的肝脏结节时的描述,美国放射学院在2011年发布了肝脏影像报告和数据管理系统,并于2013年和2014年分别进行了修订。诊断肝细胞癌的主要影像学依据为动脉期强化、门静脉期和平衡期快速廓清、有包膜或假包膜、阈值增长以及肿瘤直径。该系统将肝脏结节的定性分为5类,分别为LR-1、LR-2、LR-3、LR-4和LR-5。临床医师可根据不同的分类对肝脏异常给出不同的处理建议,如观察、定期随访、其他检查、多学科团队讨论制订治疗方案或者手术。该系统可显著提高肝细胞癌诊断准确性,具有很好的应用前景,有望成为CT和MRI检查描述和诊断肝细胞癌的金标准。

     

    Abstract: To improve standardization and consensus regarding interpreting, and reporting CT and MRI scans of the liver in patients with high risk HCC, Liver Imaging Reporting and Data System (LIRADS) was launched in 2011 and subsequently modified in 2013 and 2014, respectively. Major diagnostic imaging features for HCC are hyperenhancement in the arterial phase, rapid dissection in the portal vein phase and balance phase, capsule presence and appearance, interval threshold tumor growth and tumor diameter. LIRADS categorizes nodules recognized at CT or MRI as LR-1(definitively benign), LIRADS is a system of standardized criteria for interpreting liver CT and MR images of patients at risk of hepatocellular carcinoma in higher interobserver reliability and faster categorization while maintaining diagnostic accuracy. LR-2 (probably benign), LR-3 (intermediate probability of being HCC), LR-4 (probably HCC) and LR-5 (definitively HCC). According to diagnostic classification, different options for treatment recommendations are adopted by surgeons including continue standard surveillance, regular follow up, alternative imaging method, multidisciplinary discussion, liver resection or transplantation. LI-RADS is a system of standardized criteria for interpreting liver CT and MR images of patients at risk of hepatocellular carcinoma in higher interobserver reliability and faster categorization while maintaining diagnostic accuracy.

     

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