对于CT/MRILI-RADS类别M成像特征的读者间协议:系统性审查和元分析
Dong Hwan Kim1, Sang Hyun Choi1
1Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Journal of liver cancer
|April 15, 2024
概括
肝脏成像报告和数据系统 (LI-RADS) 类别M (LR-M) 的CT/MRI特征的读者间协议显示出变异性,特别是在外围洗和明显扩散限制方面. 改善LR-M特征评估对于准确的肝损伤表征至关重要.
科学领域:
- 放射学 放射学是一门学科.
- 医疗成像医学成像
- 肝病学 肝病学是一种肝病学.
背景情况:
- 肝脏成像报告和数据系统 (LI-RADS) 对于标准化肝脏病变的评估至关重要.
- 类别M (LR-M) 指定了在患有肝细胞癌风险的患者中暗示恶性瘤的成像特征.
- 准确的LR-M分配依赖于放射学家对特定成像特征的一致解释.
研究的目的:
- 系统地评估LI-RADS类别M (LR-M) 个别成像特征的互读器协议.
- 使用CT/MRI数据,探索导致LR-M分配差异的因素.
- 识别特定的LR-M特征,对有针对性的改进达成有限的协议.
主要方法:
- 一项对原始研究进行系统审查和元分析,报告在多相CT或MRI上对LR-M特征的读者间协议.
- 聚合的卡帕系数 (κ) 使用随机效应模型进行计算.
- 进行了子组元回归分析,以调查异质性的来源.
主要成果:
- 分析了包括5,163个肝脏观察在内的24项研究.
- 聚合的卡帕值因特征而异,对外围洗 (κ=0.52) 和明显扩散限制 (κ=0.49) 观察到有限的一致性.
- 在所有特征中都发现了显著的异质性;较小的病变大小 (<3厘米),1.5-T MRI和多个读数与较差的一致性有关.
结论:
- 对于某些LR-M特性,特别是外围冲洗和明显的扩散限制,读者之间的协议是不理想的.
- 这些发现强调了需要在LI-RADS框架内加强标准化和培训,以改善LR-M特征评估.
- 建议专注于改善对这些特定特征的协议,以提高LI-RADS v2018.2018的可靠性.
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