Shin Min Ki, Song Ji Soo, Hwang Seung Bae, Hwang Hong Pil, Kim Young Jun, Moon Woo Sung
Department of Radiology, Chonbuk National University Medical School and Hospital, Jeonju 54907, Korea.
Research Institute of Clinical Medicine of Chonbuk National University, Jeonju 54907, Korea.
Diagnostics (Basel). 2019 Aug 28;9(3):107. doi: 10.3390/diagnostics9030107.
Liver fibrosis staging is of great clinical importance because it is used to assess the severity of the underlying chronic liver disease. Among various imaging-based methods, apparent diffusion coefficient (ADC) measurement using diffusion-weighted imaging (DWI) has the potential to be used as an imaging biomarker for liver fibrosis assessment. In this study, we investigated the usefulness of liver ADC normalization using the spleen as a reference organ in liver fibrosis staging with 66 patients who underwent liver magnetic resonance imaging (MRI), transient elastography (TE), and surgical resection of a hepatic mass. ADC values of the liver (ADC) and spleen were analyzed, and the spleen was used for ADC normalization (nADC). ADC showed a weak negative correlation with TE ( = -0.246; = 0.047) and fibrosis stage ( = -0.269; = 0.029), while n ADC showed a moderate negative correlation with TE ( = -0.504; < 0.001) and fibrosis stage ( = -0.579; < 0.001). AUC values for nADC (0.777-0.875) were higher than those for ADC for each stage of fibrosis (0.596-0.713, = 0.037-0.157). AUC values for TE (0.726-0.884) and nADC were not statistically different. In conclusion, normalized liver ADC can be useful in diagnosing liver fibrosis stage in patients with variable DWI acquisitions.
肝纤维化分期具有重要的临床意义，因为它用于评估潜在慢性肝病的严重程度。在各种基于成像的方法中，使用扩散加权成像（DWI）测量表观扩散系数（ADC）有潜力作为肝纤维化评估的成像生物标志物。在本研究中，我们对66例接受肝脏磁共振成像（MRI）、瞬时弹性成像（TE）和肝脏肿块手术切除的患者，研究了以脾脏作为参考器官进行肝脏ADC标准化在肝纤维化分期中的作用。分析了肝脏（ADC）和脾脏的ADC值，并将脾脏用于ADC标准化（nADC）。ADC与TE呈弱负相关（r = -0.246；P = 0.047），与纤维化分期呈弱负相关（r = -0.269；P = 0.029），而nADC与TE呈中度负相关（r = -0.504；P < 0.001），与纤维化分期呈中度负相关（r = -0.579；P < 0.001）。各纤维化阶段nADC的曲线下面积（AUC）值（0.777 - 0.875）高于ADC的AUC值（0.596 - 0.713，P = 0.037 - 0.157）。TE的AUC值（0.726 - 0.884）与nADC无统计学差异。总之，标准化的肝脏ADC在诊断不同DWI采集患者的肝纤维化分期中可能有用。
