Kim Tae-Hoon, Jeong Chang-Won, Kim Ji Eon, Kim Jin Woong, Jo Hoon Gil, Kim Youe Ree, Lee Young Hwan, Yoon Kwon-Ha
Medical Convergence Research Center, Wonkwang University, Iksan 54538, Korea.
Smart Health IT Center, Wonkwang University Hospital, Iksan 54538, Korea.
J Clin Med. 2021 Apr 15;10(8):1697. doi: 10.3390/jcm10081697.
Image-based quantitative methods for liver heterogeneity (L) and nodularity (L) provide helpful information for evaluating liver fibrosis; however, their combinations are not fully understood in liver diseases. We developed an integrated software for assessing L and L and compared L and L according to fibrosis stages in chronic liver disease (CLD). Overall, 111 CLD patients and 16 subjects with suspected liver disease who underwent liver biopsy were enrolled. The procedures for quantifying L and L were bias correction, contour detection, liver segmentation, and L and L measurements. L and L scores among fibrosis stages (F0-F3) were compared using ANOVA with Tukey's test. Diagnostic accuracy was determined by calculating the area under the receiver operating characteristics (AUROC) curve. The mean L scores of F0, F1, F2, and F3 were 3.49 ± 0.34, 5.52 ± 0.88, 6.80 ± 0.97, and 7.56 ± 1.79, respectively ( < 0.001). The mean L scores of F0, F1, F2, and F3 were 0.84 ± 0.06, 0.91 ± 0.04, 1.09 ± 0.08, and 1.15 ± 0.14, respectively ( < 0.001). The combined L × L scores of F0, F1, F2, and F3 were 2.96 ± 0.46, 5.01 ± 0.91, 7.30 ± 0.89, and 8.48 ± 1.34, respectively ( < 0.001). The AUROCs of L, L, and L × L for differentiating F1 vs. F2 and F2 vs. F3 were 0.845, 0.958, and 0.954; and 0.619, 0.689, and 0.761, respectively. The combination of L and L scores derived from routine MR images allows better differential diagnosis of fibrosis subgroups in CLD.
基于图像的肝脏异质性（L）和结节性（L）定量方法为评估肝纤维化提供了有用信息；然而，它们在肝脏疾病中的联合应用尚未完全明确。我们开发了一种用于评估L和L的集成软件，并根据慢性肝病（CLD）的纤维化阶段比较了L和L。总共纳入了111例接受肝活检的CLD患者和16例疑似肝病患者。量化L和L的步骤包括偏差校正、轮廓检测、肝脏分割以及L和L测量。使用方差分析和Tukey检验比较纤维化阶段（F0 - F3）之间的L和L评分。通过计算受试者操作特征（AUROC）曲线下面积来确定诊断准确性。F0、F1、F2和F3的平均L评分分别为3.49±0.34、5.52±0.88、6.80±0.97和7.56±1.79（<0.001）。F0、F1、F2和F3的平均L评分分别为0.84±0.06、0.91±0.04、1.09±0.08和1.15±0.14（<0.001）。F0、F1、F2和F3的联合L×L评分分别为2.96±0.46、5.01±0.91、7.30±0.89和8.48±1.34（<0.001）。L、L和L×L区分F1与F2以及F2与F3的AUROC分别为0.845、0.958和0.954；以及0.619、0.689和0.761。从常规MR图像得出的L和L评分联合应用能够更好地对CLD中的纤维化亚组进行鉴别诊断。
