1 Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR.
2 Department of Radiology, The Shenzhen No. 3 People's Hospital, Shenzhen, Guangdong Province, China.
SLAS Technol. 2018 Jun;23(3):259-268. doi: 10.1177/2472630317717049. Epub 2017 Jun 30.
This study investigated a combined use of intravoxel incoherent motion (IVIM) parameters, Dslow ( D), PF ( f), and Dfast ( D*), for liver fibrosis evaluation. Sixteen healthy volunteers (F0) and 33 hepatitis-b patients (stage F1 = 15, stage F2-4 = 18) were included. With a 1.5 T MR scanner and respiration gating, IVIM diffusion-weighted imaging was acquired using a single-shot echo-planar imaging sequence with 10 b values of 10, 20, 40, 60, 80, 100, 150, 200, 400, and 800 s/mm. Signal measurement was performed on right liver parenchyma. With a three-dimensional tool, Dslow, PF, and Dfast values were placed along the x axis, y axis, and z axis, and a plane was defined to separate healthy volunteers from patients. The three-dimensional tool demonstrated that healthy volunteers and all patients with liver fibrosis could be separated. Classification and regression tree showed that a combination of PF (PF < 12.55%), Dslow (Dslow < 1.152 × 10 mm/s), and Dfast (Dfast < 13.36 × 10 mm/s) could differentiate healthy subjects and all fibrotic livers (F1-4) with an area under the curve of logistic regression (AUC) of 0.986. The AUC for differentiation of healthy livers versus F2-4 livers was 1. PF offered the best diagnostic value, followed by Dslow; however, all three parameters of PF, Dslow, and Dfast contributed to liver fibrosis detection.
本研究探讨了体素内不相干运动（IVIM）参数 Dslow（D）、PF（f）和 Dfast（D*）联合应用于肝纤维化评估的价值。纳入 16 名健康志愿者（F0）和 33 名乙型肝炎患者（F1 期=15 例，F2-4 期=18 例）。采用 1.5T 磁共振扫描仪和呼吸门控技术，使用单次激发平面回波成像序列采集 IVIM 扩散加权成像，共 10 个 b 值（10、20、40、60、80、100、150、200、400 和 800 s/mm）。在右肝实质上进行信号测量。使用三维工具，在 x、y 和 z 轴上分别放置 Dslow、PF 和 Dfast 值，并定义一个平面将健康志愿者与患者分开。三维工具显示，健康志愿者和所有肝纤维化患者均能被区分开。分类回归树显示，PF（PF＜12.55%）、Dslow（Dslow＜1.152×10mm/s）和 Dfast（Dfast＜13.36×10mm/s）的组合可将健康受试者和所有纤维化肝脏（F1-4）区分开来，逻辑回归曲线下面积（AUC）为 0.986。健康肝脏与 F2-4 肝脏的 AUC 为 1.0。PF 的诊断价值最高，其次是 Dslow；然而，PF、Dslow 和 Dfast 这三个参数均有助于肝纤维化的检测。
