Abstract: Objective To investigate the value of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of liver nodules in patients with suspected hepatocellular carcinoma (HCC) by using liver imaging report and data system (LI-RADS). Methods From June 2016 to December 2019, 80 patients with suspected HCC (58 males and 22 females) with an average age of (55.4 ± 9.0) years were enrolled. The Youden’s index was calculated in receiver operating characteristic (ROC) curve to determine the diagnostic cutoff points of CT and MRI. The measurement data (x ± s) were analyzed by t-test, and the counting data (%) were analyzed by chi-square test. Results There were 71 HCC lesions and 37 benign lesions (9 hepatic hemangiomas, 11 focal nodular hyperplasia, 4 hamartomas and 13 inflammatory lesions) diagnosed by operation (n = 64) and CT-guided percutaneous biopsy (n = 16). The Youden's index of CT for LI-RADS (LR) 2-5, LR 3-5, LR 4-5 and LR-5 lesions were 0, 0.190, 0.354 and 0.096, respectively. The Youden's index of MRI for LR 2-5, LR 3-5, LR 4-5 and LR-5 lesions were 0, 0.042, 0.381 and 0.150, respectively. It was suggested that both CT and MRI have best diagnostic efficacy for LR 4-5 lesions. CT had lower sensitivity, higher specificity and lower accuracy than MRI (40.8% vs.73.2%, 94.6% vs. 64.9%, 59.2% vs. 70.4%, P< 0.05). There was no significant difference in the area under ROC curve between CT and MRI. Conclusion There were differences between CT and MRI in the diagnosis of suspected HCC lesions based on LI-RADS classification. Compared with CT, MRI has obvious advantages in the suspected HCC lesion diagnosis. Generally speaking, the diagnostic value of MRI is higher than that of CT.

Key words: Hepatocellular carcinoma, Liver imaging reporting and data system, Computed tomography, Magnetic resonance imaging