中文摘要：

目的：探讨肝脏影像报告和数据管理系统（LI-RADS）CT分级诊断标准对肝细胞癌（HCC）的临床诊断价值。方法：回顾性分析158例肝癌高危患者肝脏病变患者的上腹部CT资料,并根据LI-RADS分类标准对病变进行分析评估,并与临床客观诊断结果进行比较。结果：158例患者的CT图像共发现179个肝内病灶,其中LI-RADS 1~5类病灶共167个：1类和2类48个,临床客观诊断结果均为良性（阴性预测值为100%）;3类4个;4类6个,其中2个病灶的术后病理结果为HCC（阳性预测值为33.3%）;5类109个,其中103例为HCC（阳性预测值为94.5%）。受试者工作特征（ROC）曲线下面积为0.89（P〈0.001）。若将LI-RADS 1~2类病灶归为阴性,3~5类病灶归为阳性,LI-RADS对诊断肝癌的总符合率为91.6%（153/167）,检出HCC的敏感度为100%（105/105）,特异度为77.4%（48/62）,阳性预测值为88.2%（105/119）,阴性预测值为100%（48/48）。若将LI-RADS 3类病灶排除,1~2类病灶归为阴性,4~5类病灶归为阳性,LI-RADS对肝内已检出病灶的诊断符合率为93.9%（153/163）,检出HCC的敏感度为100%（105/105）,特异度为82.8%（48/58）,阳性预测值为91.3%（105/115）,阴性预测值为100%（48/48）。结论：LI-RADS分类标准对HCC的CT诊断具有很好的诊断效果,有利于提高CT诊断报告的准确性。

英文摘要：

Objective：To evaluate the application value of liver imaging reporting and data system（LI-RADS）CT classification in the diagnosis of hepatocellular carcinoma（HCC）.Methods：158patients at high risk of HCC who underwent CT examination were enrolled.All the CT images were analyzed and the lesions were categorized into 5scales according to the LI-RADS.The diagnostic results of MRI LI-RADS were compared with the results of clinical objective diagnosis.Results：179lesions were detected in all 158 patients,including 167 lesions were diagnosed as LI-RADS category 1~5.Of167 lesions,48lesions in category 1or 2were benign lesions proved by clinical data（negative predictive value 100%）.Of the four lesions in category 3,there was no HCC.Of the six lesions in category 4,there were 2 HCCs（positive predictive value 75%）.Of 109 lesions in category 5,there were 103HCCs（positive predictive value 100%）.The area underneath the ROC curve（AUC）was 0.89 with statistic significance（P〈0.001）.If hepatic lesions in category 1and 2were considered as negative and lesions in category 3~5considered as positive,the accuracy,sensitivity,specificity,positive predictive value（PPV）and negative predictive value（NPV）of the LI-RADS classification for the diagnosis of HCC were 91.6%,100%,77.4%,88.2% and 100% respectively.If lesions in category 1and 2were considered as negative,lesions in category 4~5were considered as positive and lesions in category 3were excluded,the accuracy,sensitivity,specificity,PPV and NPV of the LI-RADS classification for diagnosis of HCC were 93.9%,100%,82.8%,91.3% and 100% respectively.Conclusion：LIRADS CT classification provides strong validity for the diagnosis of HCC,and is very useful to improve the accuracy of CT reports.