腹部磁共振弥散加权成像采用同时多层面采集技术：表观弥散系数测量的一致性和可重复性。
Abdominal Diffusion-Weighted MRI With Simultaneous Multi-Slice Acquisition: Agreement and Reproducibility of Apparent Diffusion Coefficients Measurements.
机构信息
Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
MR Collaborations, Siemens Healthineers, Shanghai, China.
出版信息
J Magn Reson Imaging. 2024 Apr;59(4):1170-1178. doi: 10.1002/jmri.28876. Epub 2023 Jun 19.
BACKGROUND
Simultaneous multi-slice diffusion-weighted imaging (SMS-DWI) can shorten acquisition time in abdominal imaging.
PURPOSE
To investigate the agreement and reproducibility of apparent diffusion coefficient (ADC) from abdominal SMS-DWI acquired with different vendors and different breathing schemes.
STUDY TYPE
Prospective.
SUBJECTS
Twenty volunteers and 10 patients.
FIELD STRENGTH/SEQUENCE: 3.0 T, SMS-DWI with a diffusion-weighted echo-planar imaging sequence.
ASSESSMENT
SMS-DWI was acquired using breath-hold and free-breathing techniques in scanners from two vendors, yielding four scans in each participant. Average ADC values were measured in the liver, pancreas, spleen, and both kidneys. Non-normalized ADC and ADCs normalized to the spleen were compared between vendors and breathing schemes.
STATISTICAL TESTS
Paired t-test or Wilcoxon signed rank test; intraclass correlation coefficient (ICC); Bland-Altman method; coefficient of variation (CV) analysis; significance level: P < 0.05.
RESULTS
Non-normalized ADCs from the four SMS-DWI scans did not differ significantly in the spleen (P = 0.262, 0.330, 0.166, 0.122), right kidney (P = 0.167, 0.538, 0.957, 0.086), and left kidney (P = 0.182, 0.281, 0.504, 0.405), but there were significant differences in the liver and pancreas. For normalized ADCs, there were no significant differences in the liver (P = 0.315, 0.915, 0.198, 0.799), spleen (P = 0.815, 0.689, 0.347, 0.423), pancreas (P = 0.165, 0.336, 0.304, 0.584), right kidney (P = 0.165, 0.336, 0.304, 0.584), and left kidney (P = 0.496, 0.304, 0.443, 0.371). Inter-reader agreements of non-normalized ADCs were good to excellent (ICCs ranged from 0.861 to 0.983), and agreement and reproducibility were good to excellent depending on anatomic location (CVs ranged from 3.55% to 13.98%). Overall CVs for abdominal ADCs from the four scans were 6.25%, 7.62%, 7.08, and 7.60%.
DATA CONCLUSION
The normalized ADCs from abdominal SMS-DWI may be comparable between different vendors and breathing schemes, showing good agreement and reproducibility. ADC changes above approximately 8% may potentially be considered as a reliable quantitative biomarker to assess disease or treatment-related changes.
LEVEL OF EVIDENCE
2 TECHNICAL EFFICACY: Stage 2.
背景
多层面弥散加权成像（SMS-DWI）可缩短腹部成像的采集时间。
目的
研究不同供应商和不同呼吸方案获得的腹部 SMS-DWI 的表观扩散系数（ADC）的一致性和可重复性。
研究类型
前瞻性。
受试者
20 名志愿者和 10 名患者。
磁场强度/序列：3.0T，SMS-DWI 采用弥散加权平面回波成像序列。
评估
在来自两个供应商的扫描仪中使用屏气和自由呼吸技术采集 SMS-DWI，每个参与者采集四组扫描。在肝脏、胰腺、脾脏和两个肾脏中测量平均 ADC 值。比较供应商和呼吸方案之间的未归一化 ADC 和归一化至脾脏的 ADC。
统计检验
配对 t 检验或 Wilcoxon 符号秩检验；组内相关系数（ICC）；Bland-Altman 方法；变异系数（CV）分析；显著性水平：P<0.05。
结果
脾脏（P=0.262，0.330，0.166，0.122）、右肾（P=0.167，0.538，0.957，0.086）和左肾（P=0.182，0.281，0.504，0.405）中，四次 SMS-DWI 扫描的未归一化 ADC 无显著差异，但在肝脏和胰腺中存在显著差异。对于归一化 ADC，肝脏（P=0.315，0.915，0.198，0.799）、脾脏（P=0.815，0.689，0.347，0.423）、胰腺（P=0.165，0.336，0.304，0.584）、右肾（P=0.165，0.336，0.304，0.584）和左肾（P=0.496，0.304，0.443，0.371）中无显著差异。未归一化 ADC 的读者间一致性良好至极好（ICC 范围为 0.861 至 0.983），并且根据解剖位置，一致性和可重复性良好至极好（CV 范围为 3.55%至 13.98%）。四次扫描的腹部 ADC 的总体 CV 为 6.25%、7.62%、7.08%和 7.60%。
数据结论
不同供应商和呼吸方案之间的腹部 SMS-DWI 归一化 ADC 可能具有可比性，表现出良好的一致性和可重复性。大约 8%以上的 ADC 变化可能被认为是评估疾病或治疗相关变化的可靠定量生物标志物。
证据水平
2 技术功效：2 级。
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