肝脏 影像 LI-RADS v20131PPT.pptx

;Introduction; LI-RADS v2013.1 features several enhancements: New algorithmic display. Expanded and refined LI-RADS lexicon. New illustrative atlas. New material on imaging technique and management. Updated criterion for tumor in vein. New OM (Other Malignancy) category to address malignant entities other than HCC that may occur in patients with cirrhosis or other risk factors for HCC. New tie-breaking rules to guide assignment of final LR category. LI-RADS v2013.1 also includes key modifications to achieve congruency between LR5 and OPTN Class 5: Capsule appearance, previously an ancillary feature, now is a major feature. The major feature, “portal venous phase or later phase hypo-enhancement relative to liver”, has been renamed washout appearance to more closely match OPTN terminology. The definition of threshold growth was updated. Ancillary features that favor HCC, which previously could be applied to upgrade category up to LR5, now can be applied to upgrade category only up to LR4. New LR5 Treated category to match OPTN 5T category.;Adjusting LI-RADS category: Assignment of LI-RADS category is described in Overview. If unsure about category, apply ancillary features to upgrade category by one or more categories (up to but not beyond LR4) or to downgrade category by one or more categories. If still unsure after applying ancillary features, then apply tie-breaking rules. ;Ancillary features: Imaging features that modify likelihood of HCC. In isolation, these features do not permit reliable categorization of observations and hence are considered ancillary. Comments: Radiologists may at their discretion apply ancillary features to adjust category as follows: Features that may favor HCC to upgrade category by one or more categories (up to but not beyond LR4). Features that may favor benignity to downgrade category by one or more categories. The reason that ancillary features cannot be used to upgrade category to LR5 is to maintain congruency with OPTN. Review when