Budjan Johannes, Sauter Elke A, Zoellner Frank G, Lemke Andreas, Wambsganss Jens, Schoenberg Stefan O, Attenberger Ulrike I
1 Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
2 Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Germany.
Acta Radiol. 2018 Jan;59(1):18-25. doi: 10.1177/0284185117706608. Epub 2017 Apr 28.
Background Functional techniques like diffusion-weighted imaging (DWI) are gaining more and more importance in liver magnetic resonance imaging (MRI). Diffusion kurtosis imaging (DKI) is an advanced technique that might help to overcome current limitations of DWI. Purpose To evaluate DKI for the differentiation of hepatic lesions in comparison to conventional DWI at 3 Tesla. Material and Methods Fifty-six consecutive patients were examined using a routine abdominal MR protocol at 3 Tesla which included DWI with b-values of 50, 400, 800, and 1000 s/mm. Apparent diffusion coefficient maps were calculated applying a standard mono-exponential fit, while a non-Gaussian kurtosis fit was used to obtain DKI maps. ADC as well as Kurtosis-corrected diffusion ( D) values were quantified by region of interest analysis and compared between lesions. Results Sixty-eight hepatic lesions (hepatocellular carcinoma [HCC] [n = 25]; hepatic adenoma [n = 4], cysts [n = 18]; hepatic hemangioma [HH] [n = 18]; and focal nodular hyperplasia [n = 3]) were identified. Differentiation of malignant and benign lesions was possible based on both DWI ADC as well as DKI D-values ( P values were in the range of 0.04 to < 0.0001). Conclusion In vivo abdominal DKI calculated using standard b-values is feasible and enables quantitative differentiation between malignant and benign liver lesions. Assessment of conventional ADC values leads to similar results when using b-values below 1000 s/mm for DKI calculation.
背景 扩散加权成像（DWI）等功能技术在肝脏磁共振成像（MRI）中越来越重要。扩散峰度成像（DKI）是一种先进技术，可能有助于克服当前DWI的局限性。目的 与3特斯拉常规DWI相比，评估DKI对肝脏病变的鉴别诊断价值。材料与方法 对56例连续患者采用3特斯拉常规腹部MR检查方案，其中包括b值为50、400、800和1000 s/mm²的DWI。应用标准单指数拟合计算表观扩散系数图，同时采用非高斯峰度拟合获得DKI图。通过感兴趣区分析对ADC以及峰度校正扩散（D）值进行量化，并在病变之间进行比较。结果 共识别出68个肝脏病变（肝细胞癌[HCC][n = 25]；肝腺瘤[n = 4]；囊肿[n = 18]；肝血管瘤[HH][n = 18]；局灶性结节性增生[n = 3]）。基于DWI ADC以及DKI D值均可实现恶性和良性病变的鉴别（P值范围为0.04至<0.0001）。结论 使用标准b值计算的体内腹部DKI是可行的，能够对肝脏良恶性病变进行定量鉴别。当使用低于1000 s/mm²的b值进行DKI计算时，评估常规ADC值可得到类似结果。
