旨在评估计算机断层扫描 (CT)/磁共振成像 (MRI) 肝脏成像报告和数据系统 (LI-RADS) 在非肝硬化脂肪变性肝病 (SLD) 患者中的表现。这项 IRB 批准的回顾性研究包括 119对 2010 年至 2023 年间接受肝脏 CT 或 MRI 的 77 名成年患者（36 名女性，41 名男性；中位年龄 64 岁）进行的观察。所有患者都有 SLD 的组织病理学证据，无肝硬化。三名经过委员会认证的腹部放射科医生对组织诊断和成像随访不知情，使用 LI-RADS 评估观察结果。计算阳性预测值 (PPV)、敏感性、特异性、准确性和读者间一致性。75 个观察结果 (63%) 为良性，44 个观察结果 (37%) 为恶性。肝细胞癌 (HCC) 的 PPV 为：LR-1 为 0-0%、LR-2 为 0-0%、LR-3 为 0-7%、LR-4 为 11-20%、LR 为 75-88% -5，LR-M 为 0-8%，LR-TIV 为 50-75%。 LR-5识别HCC的敏感性为79-83%，特异性为91-97%，准确性为89-92%。对于 LR-5、LR-M 或 LR-TIV 的复合类别识别恶性肿瘤，敏感性为 86-89%，特异性为 85-96%，准确性为 86-93%。 LR-5 最常见的假阳性是肝细胞腺瘤。只有 59-65% 的 HCC 在 CT 上显示出非外周性冲洗，而在 MRI 上则显示为 67-83%，尽管几乎所有的 HCC 都有增强的包膜。 HCC 的 PPV 和 LR-5 准确性没有因方式而异。主要特征的读者间一致性范围为 0.667 至 0.830，最终类别为 0.766。 尽管存在诸如 CT 上非外周冲洗发生率较低以及 HCC 和肝细胞腺瘤之间重叠成像特征等挑战，LI-RADS 仍可作为LI-RADS 是评估 SLD 局灶性肝脏病变的有效工具。LI-RADS 在非肝硬化脂肪性肝病中可以通过计算机断层扫描和磁共振成像有效诊断肝细胞癌和恶性肿瘤，从而指导临床管理决策并加快患者护理路径。LI 的性能-RADS 在患有脂肪肝病的非肝硬化患者中是未知的。 LI-RADS 5 类别对肝细胞癌表现出 91-97% 的高汇总特异性。 LI-RADS 可以对患有脂肪肝病的非肝硬化患者的局灶性肝脏观察结果进行非侵入性风险分层。© 2024。作者获得欧洲放射学会的独家许可。

To assess the performance of computed tomography (CT)/magnetic resonance imaging (MRI) Liver Imaging Reporting and Data System (LI-RADS) among patients with non-cirrhotic steatotic liver disease (SLD).This IRB-approved, retrospective study included 119 observations from 77 adult patients (36 women, 41 men; median 64 years) who underwent liver CT or MRI from 2010 to 2023. All patients had histopathologic evidence of SLD without cirrhosis. Three board-certified abdominal radiologists blinded to tissue diagnosis and imaging follow-up assessed observations with LI-RADS. The positive predictive value (PPV), sensitivity, specificity, accuracy, and inter-reader agreement were calculated.Seventy-five observations (63%) were benign and 44 (37%) were malignant. PPV for hepatocellular carcinoma (HCC) was 0-0% for LR-1, 0-0% for LR-2, 0-7% for LR-3, 11-20% for LR-4, 75-88% for LR-5, 0-8% for LR-M, and 50-75% for LR-TIV. For LR-5 in identifying HCC, sensitivity was 79-83%, specificity was 91-97%, and accuracy was 89-92%. For composite categories of LR-5, LR-M, or LR-TIV in identifying malignancy, sensitivity was 86-89%, specificity was 85-96%, and accuracy was 86-93%. The most common false positives for LR-5 were hepatocellular adenomas. Only 59-65% of HCCs showed non-peripheral washout at CT versus 67-83% at MRI, though nearly all had an enhancing capsule. PPV and accuracy of LR-5 for HCC did not differ by modality. Inter-reader agreement for major features ranged from 0.667 to 0.830 and was 0.766 for the final category.Despite challenges such as the lower prevalence of non-peripheral washout at CT and overlapping imaging features between HCC and hepatocellular adenomas, LI-RADS may serve as an effective tool in assessing focal liver lesions in SLD.LI-RADS in non-cirrhotic steatotic liver disease can effectively diagnose hepatocellular carcinoma and malignancy at computed tomography and magnetic resonance imaging, thereby guiding clinical management decisions and expediting patient care pathways.Performance of LI-RADS is unknown in non-cirrhotic patients with steatotic liver disease. LI-RADS 5 category showed a high pooled specificity of 91-97% for hepatocellular carcinoma. LI-RADS can non-invasively risk stratify focal liver observations in non-cirrhotic patients with steatotic liver disease.© 2024. The Author(s), under exclusive licence to European Society of Radiology.