Yamakuni Ryo, Ishikawa Hironobu, Ishii Shiro, Kakamu Takeyasu, Hara Junko, Sugawara Shigeyasu, Sekino Hirofumi, Seino Shinya, Fukushima Kenji, Ito Hiroshi
From the Department of Radiology and Nuclear Medicine, Fukushima Medical University School of Medicine.
Department of Radiology, Fukushima Medical University Hospital.
J Comput Assist Tomogr. 2024;48(2):194-199. doi: 10.1097/RCT.0000000000001561. Epub 2023 Oct 2.
To investigate the relationship between conventionally obtained serum-based biochemical indices and intravoxel incoherent motion imaging (IVIM) parameters compared with magnetic resonance elastography (MRE).
Patients with hepatocellular carcinoma who underwent ≥2 liver magnetic resonance imaging (MRI) scan, including IVIM and MRE, between 2017 and 2020 and biochemical testing within 1 week before or after MRI were included in this study. Biochemical tests were performed to determine the albumin-bilirubin (ALBI) score and modified ALBI (mALBI) grade, aspartate aminotransferase to platelet ratio index (APRI), and fibrosis-4 index (FIB-4). The diffusion coefficient ( D ), pseudo-diffusion coefficient ( D *), fractional volume occupied by flowing spins ( f ), and apparent diffusion coefficient were calculated for IVIM. The correlations between (1) the imaging parameters and biochemical indices and (2) the changes in mALBI grades and imaging parameters were evaluated.
This study included 98 scans of 40 patients (31 men; mean age, 67.7 years). The correlation analysis between the biochemical and IVIM parameters showed that ALBI score and D* had the best correlation ( r = -0.3731, P < 0.001), and the correlation was higher than that with MRE ( r = 0.3289, P < 0.001). However, among FIB-4, APRI, and MRI parameters, MRE outperformed IVIM parameters (MRE and FIB-4, r = 0.3775, P < 0.001; MRE and APRI, r = 0.4687, P < 0.001). There were significant differences in the changes in MRE among the 3 groups (improved, deteriorated, and unchanged mALBI groups) in the analysis of covariance ( P = 0.0434). There were no significant changes in IVIM.
Intravoxel incoherent motion imaging has the potential to develop into a more readily obtainable method of liver function assessment.
研究常规获取的基于血清的生化指标与体素内不相干运动成像（IVIM）参数之间的关系，并与磁共振弹性成像（MRE）进行比较。
本研究纳入了2017年至2020年间接受≥2次肝脏磁共振成像（MRI）扫描（包括IVIM和MRE）且在MRI前后1周内进行生化检测的肝细胞癌患者。进行生化检测以确定白蛋白-胆红素（ALBI）评分和改良ALBI（mALBI）分级、天冬氨酸转氨酶与血小板比值指数（APRI）以及纤维化-4指数（FIB-4）。计算IVIM的扩散系数（D）、伪扩散系数（D*）、流动自旋所占分数体积（f）和表观扩散系数。评估（1）成像参数与生化指标之间以及（2）mALBI分级变化与成像参数之间的相关性。
本研究包括40例患者的98次扫描（31例男性；平均年龄67.7岁）。生化指标与IVIM参数之间的相关性分析表明，ALBI评分与D*的相关性最佳（r = -0.3731，P < 0.001），且该相关性高于与MRE的相关性（r = 0.3289，P < 0.001）。然而，在FIB-4、APRI和MRI参数中，MRE优于IVIM参数（MRE与FIB-4，r = 0.3775，P < 0.001；MRE与APRI，r = 0.4687，P < 0.001）。在协方差分析中，3组（mALBI分级改善、恶化和不变组）的MRE变化存在显著差异（P = 0.0434）。IVIM无显著变化。
体素内不相干运动成像有潜力发展成为一种更易于获取的肝功能评估方法。
