Objetivo:
Avaliar lesões hepáticas de acordo com a classificação LI-RADS nas tomografias computadorizadas de pacientes

Materiais e Métodos:
Foram incluídos 38 pacientes com hepatite B, co-infectados ou não com vírus delta, e/ou com hepatite C crônica, que realizaram tomografia computadorizada. Dois radiologistas selecionaram até três lesões hepáticas classificadas pelo LI-RADS e avaliaram sinais de hepatopatia crônica e de hipertensão portal. Foi utilizado o teste kappa (κ) para avaliar o grau de concordância entre os radiologistas.

Resultados:
Foram selecionadas 56 observações pelo radiologista 1 e 48 pelo radiologista 2. Verificou-se que 71% e 61% dos pacientes apresentaram pelo menos uma observação hepática, segundo o radiologista 1 e o radiologista 2, respectivamente. Dos 38 pacientes, 13 (34%), segundo o radiologista 1, e 12 (32%), segundo o radiologista 2, apresentaram observações LI-RADS 5 (κ = 0,821). Hipervascularização foi detectada em 50% e 42% dos pacientes (κ = 0,668), esplenomegalia em 79% e 63% (κ = 0,503) e

Conclusão:
Detectaram-se, aproximadamente, 32% de observações LI-RADS 5 nos pacientes, com concordância quase perfeita entre os radiologistas. Houve concordância substancial/moderada entre as demais categorias LI-RADS.

Unitermos: Carcinoma hepatocelular; Cirrose hepática; Tomografia computadorizada.

Objectives:
To evaluate liver lesions, in accordance with the LI-RADS classification, using contrast-enhanced multiphase dynamic computed tomography in patients with hepatitis B, coinfected or not with hepatitis D, or with chronic hepatitis C, as well as to determine the level of agreement between radiologists.

Materials and methods:
We evaluated 38 patients with hepatitis B, coinfected or not with hepatitis D, or with chronic hepatitis C, all of whom underwent contrast-enhanced multiphase dynamic computed tomography. For each examination, two radiologists selected up to three hepatic lesions, categorizing them in accordance with the LI-RADS classification and evaluating signs of chronic liver disease and portal hypertension. To determine the level of agreement between radiologists, we calculated the kappa statistic (κ) .

Results:
Radiologist 1 and radiologist 2 selected 56 and 48 liver lesions, respectively. According to radiologist 1 and radiologist 2, respectively, 27 (71%) and 23 (61%) of the 38 patients had at least one liver lesion; 13 (34%) and 12 (32%) had a LI-RADS 5 lesion (κ = 0.821); 19 (50%) and 16 (42%) had a hypervascular lesion (κ = 0.668); and 30 (79%) and 24 (63%) had splenomegaly (κ = 0.503). Both radiologists identified chronic liver disease in 31 (82%) of the patients (κ = 1.00).

Conclusion:
Lesions categorized as LI-RADS 5 were detected in approximately 32% of the patients, with almost perfect agreement between the radiologists. The level of agreement was substantial or moderate for the other LI-RADS categories

Keywords: Carcinoma, hepatocellular; Liver cirrhosis; Tomography, X-ray computed.