Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No 151., Guangzhou, China.
Eur Radiol. 2019 Mar;29(3):1607-1615. doi: 10.1007/s00330-018-5714-6. Epub 2018 Sep 25.
To quantitatively compare the diagnostic values of various diffusion parameters obtained from mono- and biexponential diffusion-weighted imaging (DWI) models and diffusion kurtosis imaging (DKI) in differentiating between benign and malignant solitary pulmonary lesions (SPLs).
Multiple b-value DWIs and DKIs were performed in 89 patients with SPL by using a 3-T magnetic resonance (MR) imaging unit. The apparent diffusion coefficient (ADC) of various b-value sets, true diffusivity (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), apparent diffusional kurtosis (K), and kurtosis-corrected diffusion coefficient (D) were calculated and compared between the malignant and benign groups using a Mann-Whitney U test. Receiver-operating characteristic analysis was performed for all parameters.
The ADC values of malignant tumors were lower than those of the benign group (p = 0.01). The ADC, ADC, ADC ADC, ADC ADC, D, and D of malignant tumors were significantly lower than those of benign lesions (all p < 0.001). D*, f, and K showed no statistically significant differences between the two groups. ADC showed the highest area under the curve (AUC = 0.862), followed by ADC(AUC = 0.844), ADC(AUC = 0.843), D(AUC = 0.834), ADC(AUC = 0.834) and ADC(AUC = 0.824), D(AUC = 0.796), and ADC (AUC = 0.773). However, the difference in diagnostic efficacy among these parameters was not statistically significant (p > 0.05).
Intravoxel incoherent motion (IVIM) and DKI-derived parameters have similar performance compared with conventional ADC in differentiating SPLs.
• Mono- and biexponential DWI and DKI are feasible for differentiating SPLs. • ADC has better performance than ADC in assessing SPLs. • IVIM and DKI have similar performance compared with conventional DWI in differentiating SPLs.
定量比较单指数和双指数扩散加权成像（DWI）模型和扩散峰度成像（DKI）获得的各种扩散参数在鉴别良恶性孤立性肺病变（SPL）中的诊断价值。
使用 3T 磁共振（MR）成像仪对 89 例 SPL 患者进行多 b 值 DWI 和 DKI 检查。使用 Mann-Whitney U 检验比较良恶性组之间各 b 值组的表观扩散系数（ADC）、真实扩散系数（D）、假性扩散系数（D*）、灌注分数（f）、表观扩散峰度（K）和校正后的扩散系数（D）。对所有参数进行受试者工作特征分析。
恶性肿瘤的 ADC 值低于良性组（p = 0.01）。恶性肿瘤的 ADC、ADC、ADC、ADC、ADC、D 和 D 均明显低于良性病变（均 p < 0.001）。两组间 D*、f 和 K 无统计学差异。ADC 的曲线下面积（AUC）最高（AUC = 0.862），其次是 ADC（AUC = 0.844）、ADC（AUC = 0.843）、D（AUC = 0.834）、ADC（AUC = 0.834）和 ADC（AUC = 0.824）、D（AUC = 0.796）和 ADC（AUC = 0.773）。然而，这些参数的诊断效能差异无统计学意义（p > 0.05）。
体素内不相干运动（IVIM）和 DKI 衍生参数与常规 ADC 相比，在鉴别 SPL 方面具有相似的性能。
单指数和双指数 DWI 和 DKI 可用于鉴别 SPL。
ADC 在评估 SPL 方面比 ADC 表现更好。
IVIM 和 DKI 在鉴别 SPL 方面与常规 DWI 具有相似的性能。
