Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China.
Department of Pathology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China.
Abdom Radiol (NY). 2017 Apr;42(4):1176-1182. doi: 10.1007/s00261-016-0984-4.
To investigate and compare the diagnostic value of diffusion kurtosis imaging (DKI) with diffusion-weighted imaging (DWI) in assessing and quantifying hepatic fibrosis.
Thirty rats were divided into the control group (n = 6) and the fibrosis experimental groups (n = 6 per group) with CCl administration for 2, 4, 6, and 8 weeks. Liver fibrosis stage (S) and necroinflammatory activity grade (G) were histopathologically determined. DKI and DWI were performed; mean apparent diffusion (MD), mean kurtosis (MK), and apparent diffusion coefficient (ADC) values were calculated. DKI parameters were compared with ADC values according to G/S scores.
Strong inverse correlations were found between the degree of fibrosis and both MD and ADC (r = -0.840 and r = -0.760), while only weak correlation existed in MK (r = 0.405). ROC analyses demonstrated the AUC in MD, MK, and ADC of 0.862, 0.684, 0.817 for identifying mild and severe fibrosis, and 0.757, 0.675, 0.733 for non-cirrhosis and cirrhosis, respectively. The degree of fibrosis was significantly correlated with α-smooth muscle actin (α-SMA) (P < 0.0001); α-SMA had strong inverse correlation with MD (r = -0.723), moderate inverse correlation with ADC (r = -0.613), and very weak correlation with MK (r = 0.175). Additionally, MD was strongly correlated with the necroinflammatory activity (r = -0.758), ADC was moderately correlated (r = -0.492), and MK was weakly correlated (r = 0.254).
DKI may provide added information and serve as a valuable tool for the characterization and surveillance of liver fibrosis in a non-invasive manner.
探讨和比较扩散峰度成像（DKI）与扩散加权成像（DWI）在评估和量化肝纤维化中的诊断价值。
30 只大鼠分为对照组（n=6）和纤维化实验组（每组 n=6，用 CCl 处理 2、4、6 和 8 周）。肝纤维化分期（S）和坏死性炎症活动度分级（G）采用组织病理学确定。进行 DKI 和 DWI 检查；计算平均表观扩散（MD）、平均峰度（MK）和表观扩散系数（ADC）值。根据 G/S 评分比较 DKI 参数与 ADC 值。
纤维化程度与 MD 和 ADC 呈强负相关（r=-0.840 和 r=-0.760），而 MK 仅存在弱相关（r=0.405）。ROC 分析表明，MD、MK 和 ADC 对轻度和重度纤维化的 AUC 分别为 0.862、0.684 和 0.817，对非肝硬化和肝硬化的 AUC 分别为 0.757、0.675 和 0.733。纤维化程度与α-平滑肌肌动蛋白（α-SMA）显著相关（P<0.0001）；α-SMA 与 MD 呈强负相关（r=-0.723），与 ADC 呈中度负相关（r=-0.613），与 MK 呈弱相关（r=0.175）。此外，MD 与坏死性炎症活动度呈强负相关（r=-0.758），ADC 呈中度负相关（r=-0.492），MK 呈弱相关（r=0.254）。
DKI 可以提供附加信息，并且可以作为一种有价值的工具，用于无创性地对肝纤维化进行特征描述和监测。
