Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China.
Department of Immunology and Rheumatology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China.
Korean J Radiol. 2022 Apr;23(4):455-465. doi: 10.3348/kjr.2021.0695. Epub 2022 Mar 8.
To compare the reproducibility and performance of quantitative metrics between ZOOMit and conventional intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) in the diagnosis of early- and mid-stage Sjögren's syndrome (SS).
Twenty-two patients (mean age ± standard deviation, 52.0 ± 10.8 years; male:female, 2:20) with early- or mid-stage SS and 20 healthy controls (46.9 ± 14.6 years; male:female, 7:13) were prospectively enrolled in our study. ZOOMit IVIM and conventional IVIM MRI were performed simultaneously in all individuals using a 3T scanner. Quantitative IVIM parameters - including tissue diffusivity (D), pseudodiffusion coefficient (D), and perfusion fraction (f) - inter- and intra-observer reproducibility in measuring these parameters, and their ability to distinguish patients with SS from healthy individuals were assessed and compared between ZOOMit IVIM and conventional IVIM methods, appropriately. MR gland nodular grade (MRG) was also examined.
Inter- and intra-observer reproducibility was better with ZOOMit imaging than with conventional IVIM imaging (ZOOMit vs. conventional, intraclass correlation coefficient of 0.897-0.941 vs. 0.667-0.782 for inter-observer reproducibility and 0.891-0.968 vs. 0.814-0.853 for intra-observer reproducibility). Significant differences in ZOOMit f, ZOOMit D, conventional D, and MRG between patients with SS and healthy individuals (all < 0.05) were observed. ZOOMit D outperformed conventional D in diagnosing early- and mid-stage SS (area under receiver operating curve, 0.867 and 0.658, respectively; = 0.002). The combination of ZOOMit D, MRG, and ZOOMit f as a new diagnostic index for SS, increased diagnostic area under the curve to 0.961, which was higher than that of any single parameter (all < 0.01).
Considering its better reproducibility and performance, ZOOMit IVIM may be preferred over conventional IVIM MRI, and may subsequently improve the ability to diagnose early- and mid-stage SS.
比较 ZOOMit 与传统体素内不相干运动（IVIM）磁共振成像（MRI）定量指标在早期和中期干燥综合征（SS）诊断中的可重复性和性能。
前瞻性纳入 22 例早期或中期 SS 患者（平均年龄±标准差，52.0±10.8 岁；男：女=2：20）和 20 例健康对照者（46.9±14.6 岁；男：女=7：13）。所有个体均在 3T 扫描仪上同时进行 ZOOMit IVIM 和传统 IVIM MRI。评估并比较了 ZOOMit IVIM 和传统 IVIM 方法在测量这些参数的观察者内和观察者间可重复性、区分 SS 患者和健康个体的能力，以及 MR 腺结节分级（MRG）。
ZOOMit 成像的观察者内和观察者间可重复性均优于传统 IVIM 成像（ZOOMit 与传统 IVIM 观察者间可重复性的组内相关系数分别为 0.897-0.941 与 0.667-0.782，观察者内可重复性分别为 0.891-0.968 与 0.814-0.853）。SS 患者与健康个体之间的 ZOOMit f、ZOOMit D、传统 D 和 MRG 存在显著差异（均<0.05）。ZOOMit D 在诊断早期和中期 SS 方面优于传统 D（曲线下面积分别为 0.867 和 0.658，=0.002）。将 ZOOMit D、MRG 和 ZOOMit f 组合作为 SS 的新诊断指标，诊断曲线下面积增加至 0.961，高于任何单一参数（均<0.01）。
考虑到其更好的可重复性和性能，ZOOMit IVIM 可能优于传统 IVIM MRI，进而提高早期和中期 SS 的诊断能力。
