Abstract: Objective To explore the liver imaging report and data management system (LI-RADS) in CT and MR imaging in diagnosis of patients with hepatocellular carcinoma (HCC). Methods 200 patients with high risk for HCC, such as chronic hepatitis B, cirrhosis, alcohol abuse and elevated serum alpha-fetoprotien levels were recruited and all patients underwent CT and MRI plain and enhancement scan. The imaging was evaluated according to the LI-RADS v2017 grading criteria. The evaluation was performed by two radiologists, and the consistency of one doctor was evaluated one month later. In LI-RADS grading, LR-1 and LR-2 were considered benign lesions, while LR-4, LR-5, and LR-5TIV were malignant lesions. The results of pathology were acted as gold standard of diagnosis. Finally, the sensitivity, specificity, and accuracy of LI-RADS diagnosis were calculated. Results We enrolled 200 patients, and all finished CT and MRI; the histopathological examination showed that there were 125 patients with HCCs, 27 with intrahepatic cholangiocarcinomas, 9 with metastasis, and 39 with benign lesions; by LI-RADS classification, 17 cases were diagnosed as benign, and 151 cases as malignant by CT scan, while 17 cases were diagnosed as benign, and 169 cases as malignant by MRI; in CT diagnosis, the Kappa value was 0.912 (P<0.001), while the data of MR diagnosis showed the Kappa value was 1.000 (P<0.001), indicating that the diagnostic accuracy by using LI-RADS grading in MR examination was superior to that of CT scan; by LI-RADS grading standard, the sensitivity, specificity and accuracy of CT scan were 95.4%, 81.2% and 90.2%, while those of MRI were 100%, 85.4% and 92.4%. Conclusion The LI-RADS based on CT and MRI has a very good repeatability and high accuracy in the evaluation of HCC, the possibility for HCC is quite greater in CT-evaluated LR-3 lesions, thus, Gd-DTPA enhancement of MRI is firmly recommended for such patients. We suggest that the patients with LR-3 lesions by MRI scan should be regularly followed-up.

Key words: Hepatocellular carcinoma, CT, MRI, Liver imaging report and data management system, Diagnosis