Pawluś Aleksander, Szymańska Kinga, Łasecki Mateusz, Bladowska Joanna, Sokołowska-Dąbek Dąbrówka, Szumarska-Czech Małgorzata, Kaczorowski Krzysztof, Markiewicz Bartosz D, Dudek Krzysztof, Zaleska-Dorobisz Urszula
Department of General and Pediatric Radiology, Independent Public Clinical Hospital No. 1, Wrocław, Poland.
Department of Radiology, Wroclaw Medical University, Poland.
Adv Clin Exp Med. 2017 Aug;26(5):811-816. doi: 10.17219/acem/60877.
Diffusion weighted imaging (DWI) is a useful tool for the evaluation of focal lesions in the liver or kidneys, as well as for the diagnosis and assessment of the liver fibrosis process. Some reports show that the spleen and kidneys may serve as reference organs in the staging of liver fibrosis or the evaluation of focal liver lesions.
The aim of the study was to determine whether the spleen and renal cortex can be used as reference organs in the DWI technique.
The study group included 36 patients with no liver, spleen or renal pathologies and without any infections or hematologic disease. All the examinations were performed using a 1.5T MR unit with a conventional phased array body coil. Image interpretation and apparent diffusion coefficient (ADC) measurements were done by 3 experienced radiologists.
There was a statistically significant difference between the ADC values noted by 2 of the examiners in the upper/middle and lower part of the spleen parenchyma. There were no statistically significant differences between the ADC values obtained by all 3 examiners in all the parts of each kidney. There were no statistically significant differences between the examiners' ADC values for the spleen and kidneys. The mean ADC values for the left kidney showed the highest measurement reproducibility.
The study showed that the renal cortex seems to be an appropriate region for performing reference ADC measurements. Further studies on a larger group of patients and using various DWI protocols should be performed to ascertain the best conditions for maximizing the reproducibility of ADC measurements.
扩散加权成像（DWI）是评估肝脏或肾脏局灶性病变以及诊断和评估肝纤维化进程的有用工具。一些报告表明，脾脏和肾脏可作为肝纤维化分期或局灶性肝病变评估的参考器官。
本研究旨在确定在DWI技术中脾脏和肾皮质是否可作为参考器官。
研究组包括36例无肝脏、脾脏或肾脏病变且无任何感染或血液系统疾病的患者。所有检查均使用配备传统相控阵体线圈的1.5T磁共振成像设备进行。图像解读和表观扩散系数（ADC）测量由3名经验丰富的放射科医生完成。
两位检查者在脾实质上部/中部和下部记录的ADC值之间存在统计学显著差异。三位检查者在每个肾脏各部位获得的ADC值之间无统计学显著差异。检查者对脾脏和肾脏的ADC值之间无统计学显著差异。左肾的平均ADC值显示出最高的测量重复性。
该研究表明，肾皮质似乎是进行参考ADC测量的合适区域。应开展对更大患者群体并采用各种DWI方案的进一步研究，以确定使ADC测量重复性最大化的最佳条件。
