Salahshour Faeze, Khameneh Afshar Ghamari, Amirkhiz Gisoo Darban Hosseini, Yazdi Niloofar Ayoobi, Shafiekhani Sajad
Department of Radiology, Advanced Diagnostic and Interventional Radiology (ADIR) Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Liver Transplantation Research Center, Imam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Pol J Radiol. 2023 Dec 21;88:e589-e596. doi: 10.5114/pjr.2023.134043. eCollection 2023.
We investigated the diagnostic power of texture analysis (TA) performed on MRI (T2-weighted, gadolinium-enhanced, and diffusion-weighted images) to differentiate between focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA).
This was a retrospective single-centre study. Patients referred for liver lesion characterization, who had a definitive pathological diagnosis, were included. MRI images were taken by a 3-Tesla scanner. The values of TA parameters were obtained using the ImageJ platform by an observer blinded to the clinical and pathology judgments. A non-parametric Mann-Whitney test was applied to compare parameters between the 2 groups. With receiver operating characteristic (ROC) analysis, the area under the curve (AUC), sensitivity, and specificity were calculated. Finally, we performed a binary logistic regression analysis. A -value <0.05 was reported as statistically significant.
A total of 62 patients with 106 lesions were enrolled. T2 hyperintensity, Atoll sign, and intralesional fat were encountered more in HCAs, and central scars were more frequent in FNHs. Multiple TA features showed statistically significant differences between FNHs and HCAs, including skewness on T2W and entropy on all sequences. Skewness on T2W revealed the most significant AUC (0.841, good, < 0.0001). The resultant model from binary logistic regression was statistically significant ( < 0.0001) and correctly predicted 84.1% of lesions. The corresponding AUC was 0.942 (excellent, 95% CI: 0.892-0.992, < 0.0001).
Multiple first-order TA parameters significantly differ between these lesions and have almost fair to good diagnostic power. They have differentiation potential and can add diagnostic value to routine MRI evaluations.
我们研究了在MRI（T2加权、钆增强和扩散加权图像）上进行的纹理分析（TA）区分局灶性结节性增生（FNH）和肝细胞腺瘤（HCA）的诊断能力。
这是一项回顾性单中心研究。纳入了因肝脏病变特征而转诊且有明确病理诊断的患者。MRI图像由3特斯拉扫描仪采集。TA参数值由一名对临床和病理判断不知情的观察者使用ImageJ平台获得。应用非参数曼-惠特尼检验比较两组之间的参数。通过受试者操作特征（ROC）分析，计算曲线下面积（AUC）、敏感性和特异性。最后，我们进行了二元逻辑回归分析。P值<0.05被报告为具有统计学意义。
共纳入62例患者的106个病变。HCA中T2高信号、环礁征和病灶内脂肪更为常见，而FNH中中央瘢痕更为常见。多个TA特征在FNH和HCA之间显示出统计学显著差异，包括T2加权像上的偏度和所有序列上的熵。T2加权像上的偏度显示出最显著的AUC（0.841，良好，P<0.0001）。二元逻辑回归得到的模型具有统计学意义（P<0.0001），并正确预测了84.1%的病变。相应的AUC为0.942（优秀，95%CI：0.892 - 0.992，P<0.0001）。
这些病变之间多个一阶TA参数存在显著差异，具有近乎中等至良好的诊断能力。它们具有鉴别潜力，可为常规MRI评估增加诊断价值。
