Determination of Malignancy and Characterization of Hepatic Tumor Type With Diffusion-Weighted Magnetic Resonance Imaging Comparison of Apparent Diffusion Coefficient and Intravoxel Incoherent Motion-Derived Measurements
Determination of Malignancy and Characterization of Hepatic Tumor Type With Diffusion-Weighted Magnetic Resonance Imaging Comparison of Apparent Diffusion Coefficient and Intravoxel Incoherent Motion-Derived Measurements
复制标题
DOI：
10.1097/rli.0b013e3182915912
复制
发表时间：
2013-10-01
影响因子：
6.7
通讯作者：
Van Beers, Bernard E.
中科院分区：
文献类型：
--
作者：
Doblas, Sabrina;Wagner, Mathilde;Van Beers, Bernard E.
目的：本研究的目的是比较3个B值确定的表观扩散系数（ADC）值和体素内非相干运动（IVIM）衍生参数在确定肝脏肿瘤恶性程度和表征肿瘤类型中的价值。材料和方法：76例患者共86个肝脏实性病变，其中血管瘤8个，局灶性结节增生20个，腺瘤9个，肝癌30个，在这项前瞻性研究中评估了13例转移瘤和6例胆管癌。采用11个B值采集弥散加权图像，以测量ADC（B = 0、150和500 s/mm（2））和IVIM衍生参数，即纯弥散系数和灌注相关弥散分数和系数。结果：良性肿瘤的表观扩散系数和纯扩散系数均明显高于恶性肿瘤，而良性肿瘤的表观扩散系数和纯扩散系数均明显高于恶性肿瘤（良性：2.32 [0.87] x 10（-3）mm（2）/S和1.42 [0.37] x 10（-3）mm（2）/S;恶性：1.64 [0.51] x 10（-3）mm（2）/S和1.14 [0.28] x 10（3）11=2/S; P < 0.0001和P = 0.0005），而两组之间的灌注相关弥散参数无显著差异。表观扩散系数和纯扩散系数在评估肿瘤恶性程度方面提供了相似的准确性（受试者工作特征曲线下的面积分别为0.770和0.723）。在多组分析中，血管瘤的ADC值显著高于肝细胞癌、转移瘤和胆管癌。同样，局灶性结节性增生病变中的表达高于转移瘤和胆管癌。然而，纯扩散系数显着较高，只有在血管瘤与肝细胞和胆管细胞carcinoma.Conclusions：ADC相比，来自IVIM模型的扩散参数并没有提高恶性程度的测定和表征肝肿瘤类型。
Objective: The objective of this study was to compare the value of the apparent diffusion coefficient (ADC) determined with 3 b values and the intravoxel incoherent motion (IVIM)-derived parameters in the determination of malignancy and characterization of hepatic tumor type.Materials and Methods: Seventy-six patients with 86 solid hepatic lesions, including 8 hemangiomas, 20 lesions of focal nodular hyperplasia, 9 adenomas, 30 hepatocellular carcinomas, 13 metastases, and 6 cholangiocarcinomas, were assessed in this prospective study. Diffusion-weighted images were acquired with 11 b values to measure the ADCs (with b = 0, 150, and 500 s/mm(2)) and the IVIM-derived parameters, namely, the pure diffusion coefficient and the perfusion-related diffusion fraction and coefficient. The diffusion parameters were compared between benign and malignant tumors and between tumor types, and their diagnostic value in identifying tumor malignancy was assessed.Results: The apparent and pure diffusion coefficients were significantly higher in benign than in malignant tumors (benign: 2.32 [0.87] x 10(-3) mm(2)/S and 1.42 [0.37] x 10(-3) mm(2)/s vs malignant: 1.64 [0.51] x 10(-3) mm(2)/S and 1.14 [0.28] x iO(3) 11=2/S, respectively; P < 0.0001 and P = 0.0005), whereas the perfusion-related diffusion parameters did not differ significantly between the 2 groups. The apparent and pure diffusion coefficients provided similar accuracy in assessing tumor malignancy (areas under the receiver operating characteristic curve of 0.770 and 0.723, respectively). In the multigroup analysis, the ADC was found to be significantly higher in hemangiomas than in hepatocellular carcinomas, metastases, and cholangiocarcinomas. In the same manner, it was higher in lesions of focal nodular hyperplasia than in metastases and cholangiocarcinomas. However, the pure diffusion coefficient was significantly higher only in hemangiomas versus hepatocellular and cholangiocellular carcinomas.Conclusions: Compared with the ADC, the diffusion parameters derived from the IVIM model did not improve the determination of malignancy and characterization of hepatic tumor type.