Intravoxel incoherent motion diffusion-weighted MRI for the characterization of inflammation in chronic liver disease
Intravoxel incoherent motion diffusion-weighted MRI for the characterization of inflammation in chronic liver disease
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DOI：
10.1007/s00330-020-07203-y
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发表时间：
2020-09-02
影响因子：
5.9
通讯作者：
Tang, An
中科院分区：
文献类型：
--
作者：
Lefebvre, Thierry;Hebert, Melanie;Tang, An
目的评价体素内非相干运动（IVIM）弥散加权成像（DWI）对肝脏炎症分级的诊断价值。方法在这项回顾性横断面双中心研究中，2014年9月至2018年9月期间招募了91例慢性肝病患者。患者在肝活检后6周内接受了3.0 T MRI检查。IVIM参数、灌注分数（f）、扩散系数（D）和伪扩散系数（D*）使用DWI系列（10 b值从0到800 s/mm（2））的体素非线性回归进行估计。参考标准为肝脏炎症分级、脂肪变性分级和纤维化分期的组织病理学分析。评估组内相关系数（ICC）、单变量和多变量相关分析以及受试者工作特征曲线下面积（AUC）。结果参数sf、D和D * 的ICC值分别为0.860、0.839和0.916。与炎症分级的相关性分别为：rho =-0.70，p = 0.0001;rho = 0.10，p = 0.35; rho =-0.27，p = 0.010。当调整纤维化和脂肪变性时，f和炎症之间的相关性（p < 0.0001）仍然存在，f和纤维化之间的相关性也在较小程度上显著（p = 0.002）。用于区分炎症等级0与>= 1的AUC off、D和D * 为0.84、0.53和0.70;>= 2的AUC off、D和D * 为0.88、0.57和0.60;并且
Objective To evaluate the diagnostic performance of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) for grading hepatic inflammation. Methods In this retrospective cross-sectional dual-center study, 91 patients with chronic liver disease were recruited between September 2014 and September 2018. Patients underwent 3.0-T MRI examinations within 6 weeks from a liver biopsy. IVIM parameters, perfusion fraction (f), diffusion coefficient (D), and pseudo-diffusion coefficient (D*), were estimated using a voxel-wise nonlinear regression on DWI series (10b-values from 0 to 800 s/mm(2)). The reference standard was histopathological analysis of hepatic inflammation grade, steatosis grade, and fibrosis stage. Intraclass correlation coefficients (ICC), univariate and multivariate correlation analyses, and areas under receiver operating characteristic curves (AUC) were assessed. Results Parametersf,D, andD*had ICCs of 0.860, 0.839, and 0.916, respectively. Correlations off,D, andD*with inflammation grade were rho = - 0.70,p < 0.0001;rho = 0.10,p = 0.35; and rho = - 0.27,p = 0.010, respectively. When adjusting for fibrosis and steatosis, the correlation betweenfand inflammation (p < 0.0001) remained, and that betweenfand fibrosis was also significant to a lesser extent (p = 0.002). AUCs off,D, andD*for distinguishing inflammation grades 0 vs. >= 1 were 0.84, 0.53, and 0.70; = 2 were 0.88, 0.57, and 0.60; and