IVIM-DWI基于肝段水平对肝纤维化患者测量的可重复性及诊断效能
Repeatability and diagnostic efficacy of IVIM-DWI measurement in patients with hepatic fibrosis based on liver segment level
黄乐生 1张晚春 1唐嘉慧 1刘天柱1
作者信息
- 1. 广东省中医院珠海医院影像科,广东珠海 519000
- 折叠
摘要
目的 评估肝纤维化患者应用体素内不相干运动扩散加权成像(IVIM-DWI)测量的可重复性,并评估基于肝右叶肝段的IVIM-DWI相关参数对早期及中晚期肝纤维化的诊断效能.方法 2020年6月～2022年9月期间招募早期肝纤维化及晚期肝纤维化患者,使用IVIM-DWI序列进行肝脏扫描.两名检查者基于肝右叶各段水平,应用单指数模型、双指数模型和拉伸指数模型测量相关参数数据.对获得的测量数据应用变异系数(CV)进行可重复性检验,剔除可重复性较低(CV＞20%)的肝段参数后,用Logistic回归分析最终纳入的IVIM-DWI参数,计算诊断效能并描绘ROC曲线.结果 59名早期肝纤维化和38名晚期肝纤维化患者被纳入研究.获得的数据中,D*(CV:29.25%～41.47%)和DDC(CV:22.44%～30.63%)的可重复性较差,而ADC(CV:5.29%～9.76%)、D(9.53%～13.22%)、f(CV:12.83%～16.95%)和α(CV:8.82%～15.52%)的可重复性较好.剔除可重复性较低的参数后,Logistic回归分析建立早期肝纤维化与晚期肝纤维化组的诊断模型并描绘ROC曲线,最终纳入模型的肝段水平参数为SⅦ D及SⅧ f,最终回归模型的曲线下面积(AUC)为0.857.结论 基于肝段的高可重复性,IVIM-DWI对肝纤维化仍能获得较好的诊断效能,其中D、f参数以及肝右叶上段SⅦ、SⅧ在满足可重复性的前提下,可能是较稳定的肝纤维化分级诊断因素.
Abstract
Objective To evaluate the repeatability of intravoxel incoherent motion diffusion weighted imaging(IVIM-DWI)related parameters in patients with hepatic fibrosis(HF),and to evaluate the diagnostic efficacy of IVIM-DWI related parameters based on the right hepatic segment for early and adavance hepatic fibrosis.Methods From June 2020 to September 2022,patients with early HF and advanced HF were recruited for liver scanning using IVIM-DWI.Two examiners measured and analyzed the IVIM images obtained by scanning using mono-,bi-,and stretched-exponential models based on the levels of each segment of the right liver lobe.The measurement data were tested for repeatability using a coefficient of variation(CV).After eliminating IVIM-DWI parameters with low repeatability(CV>20%),binary Logistic regression was used to analyze the IVIM-DWI parameters,and the diagnostic efficiency of the included IVIM-DWI parameters was tested and the ROC curve was plotted.Results 59 patients with early HF and 38 patients with advanced HF were included in the study.Among the obtained data,the repeatability of D*(CV:29.25～41.47%)and DDC(CV:22.44～30.63%)was poor,while that of ADC(CV:5.29%～9.76%),D(CV:9.53%～13.22%),f(CV:12.83%～16.95%%)and α(CV:8.82%～15.52%)showed a good repeatability.After eliminating the parameters with low repeatability,Logistic regression analysis was used to establish diagnostic models of early HF and advanced HF,and the ROC curves were plotted.The final liver segment level parameters included in the models were SⅦ D and SⅧ f.The area under curve(AUC)of the final regression model was 0.857.Conclusion Based on the high repeatability of liver segments,IVIM-DWI can still obtain satisfied diagnostic efficacy for HF,and the D,f parameters,and SⅦ,SⅧ in the right liver lobe may be more stable diagnostic factors affecting diagnostic efficacy on the premise of satisfying repeatability.
关键词
肝段/弥散加权成像/体素内不相干运动/肝纤维化/可重复性Key words
Liver segment/Diffusion weighted imaging/Intravoxel incoherent motion/Hepatic fibrosis/Repeatability引用本文复制引用
基金项目
珠海市医学科研项目(2220009000170)
出版年
2024
NETL
NSTL
万方数据