用于临床研究的扩散张量成像（DTI）分析方法比较：预处理和纤维束选择方法的影响
Comparison of DTI analysis methods for clinical research: influence of pre-processing and tract selection methods.
作者信息
Ressel Volker, van Hedel Hubertus J A, Scheer Ianina, O'Gorman Tuura Ruth
机构信息
Centre MR-Research, University Children's Hospital, Zurich, Switzerland.
Rehabilitation Centre, University Children's Hospital, Mühlebergstrasse 104, CH-8910, Affoltern am Albis, Switzerland.
出版信息
Eur Radiol Exp. 2018 Nov 14;2(1):33. doi: 10.1186/s41747-018-0066-1.
BACKGROUND
The primary aim was to compare fractional anisotropy (FA) values derived with different diffusion tensor imaging (DTI) analysis approaches (atlas-based, streamline tractography, and combined). A secondary aim was to compare FA values and number of tracts (NT) with the clinical motor outcome quantified by the functional independence measure for children (WeeFIM).
METHODS
Thirty-nine DTI datasets of children with acquired brain injury were analysed. Regions of interest for the ipsilesional corticospinal tract were defined and mean FA and NT were calculated. We evaluated FA values with Spearman correlation, the Friedman and Wilcoxon tests, and Bland-Altman analysis. DTI values were compared to WeeFIM values by non-parametric partial correlation and accuracy was assessed by receiver operating characteristics analysis.
RESULTS
The FA values from all approaches correlated significantly with each other (p < 0.001). However, the FA values from streamline tractography were significantly higher (mean ± standard deviation (SD), 0.52 ± 0.08) than those from the atlas-based (0.42 ± 0.11) or the combined approach (0.41 ± 0.11) (p < 0.001 for both). FA and NT values correlated significantly with WeeFIM values (atlas-based FA, partial correlation coefficient (ρ) = 0.545, p = 0.001; streamline FA, ρ = 0.505, p = 0.002; NT, ρ = 0.434, p = 0.008; combined FA, ρ = 0.611, p < 0.001). FA of the atlas-based approach (sensitivity 90%, specificity 67%, area under the curve 0.82) and the combined approach (87%, 67%, 0.82), provided the highest predictive accuracy for outcome compared to FA (70%, 67%, 0.67) and NT (50%, 100%, 0.79, respectively) of the streamline approach.
CONCLUSION
FA values from streamline tractography were higher than those from the atlas-based and combined approach. The atlas-based and combined approach offer the best predictive accuracy for motor outcome, although both atlas-based and streamline tractography approaches provide significant predictors of clinical outcome.
背景
主要目的是比较采用不同扩散张量成像（DTI）分析方法（基于图谱法、流线追踪法和联合法）得出的分数各向异性（FA）值。次要目的是将FA值和纤维束数量（NT）与通过儿童功能独立性测量（WeeFIM）量化的临床运动结果进行比较。
方法
分析了39例获得性脑损伤儿童的DTI数据集。定义了患侧皮质脊髓束的感兴趣区，并计算了平均FA值和NT值。我们采用Spearman相关性分析、Friedman检验和Wilcoxon检验以及Bland-Altman分析来评估FA值。通过非参数偏相关性分析将DTI值与WeeFIM值进行比较，并通过受试者工作特征分析评估准确性。
结果
所有方法得出的FA值之间均显著相关（p < 0.001）。然而，流线追踪法得出的FA值（均值±标准差（SD），0.52±0.08）显著高于基于图谱法（0.42±0.11）或联合法（0.41±0.11）得出的FA值（两者均p < 0.001）。FA值和NT值与WeeFIM值显著相关（基于图谱法的FA，偏相关系数（ρ） = 0.545，p = 0.001；流线追踪法的FA，ρ = 0.505，p = 0.002；NT，ρ = 0.434，p = 0.008；联合法的FA，ρ = 0.611，p < 0.001）。与流线追踪法的FA（70%，67%，0.67）和NT（分别为50%，100%，0.79）相比，基于图谱法（敏感性90%，特异性67%，曲线下面积0.82）和联合法（87%，67%，0.82）的FA对结果的预测准确性最高。
结论
流线追踪法得出的FA值高于基于图谱法和联合法得出的FA值。基于图谱法和联合法对运动结果的预测准确性最佳，尽管基于图谱法和流线追踪法均能提供临床结果的显著预测指标。
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