Liu Xiang, Wang Yi-Feng, Qi Xiao-Hui, Zhang Zhi-Lei, Pan Jiang-Yang, Fan Xue-Li, Du Yu, Zhai Ying-Min, Wang Qi
Department of CT and MRI, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China.
World J Gastrointest Surg. 2024 Jul 27;16(7):2031-2039. doi: 10.4240/wjgs.v16.i7.2031.
The consistency of pancreatic apparent diffusion coefficient (ADC) values and intravoxel incoherent motion (IVIM) parameter values across different magnetic resonance imaging (MRI) devices significantly impacts the patient's diagnosis and treatment.
To explore consistency in image quality, ADC values, and IVIM parameter values among different MRI devices in pancreatic examinations.
This retrospective study was approved by the local ethics committee, and informed consent was obtained from all participants. In total, 22 healthy volunteers (10 males and 12 females) aged 24-61 years (mean, 28.9 ± 2.3 years) underwent pancreatic diffusion-weighted imaging using 3.0T MRI equipment from three vendors. Two independent observers subjectively scored image quality and measured the pancreas's overall ADC values and signal-to-noise ratios (SNRs). Subsequently, regions of interest (ROIs) were delineated for the IVIM parameters (true diffusion coefficient, pseudo-diffusion coefficient, and perfusion fraction) using post-processing software. These ROIs were on the head, body, and tail of the pancrease. The subjective image ratings were assessed using the kappa consistency test. Intraclass correlation coefficients (ICCs) and mixed linear models were used to evaluate each device's quantitative parameter values. Finally, a pairwise analysis of IVIM parameter values across each device was performed using Bland-Altman plots.
The Kappa value for the subjective ratings of the different observers was 0.776 ( < 0.05). The ICC values for inter-observer and intra-observer agreements for the quantitative parameters were 0.803 [95% confidence interval (CI): 0.684-0.880] and 0.883 (95%CI: 0.760-0.945), respectively ( < 0.05). The ICCs for the SNR between different devices was comparable ( > 0.05), and the ICCs for the ADC values from different devices were 0.870, 0.707, and 0.808, respectively ( < 0.05). Notably, only a few statistically significant inter-device agreements were observed for different IVIM parameters, and among those, the ICC values were generally low. The mixed linear model results indicated differences ( < 0.05) in the -value for the pancreas head, -value for the pancreas body, and -value for the pancreas tail obtained using different MRI machines. The Bland-Altman plots showed significant variability at some data points.
ADC values are consistent among different devices, but the IVIM parameters' repeatability is moderate. Therefore, the variability in the IVIM parameter values may be associated with using different MRI machines. Thus, caution should be exercised when using IVIM parameter values to assess the pancreas.
胰腺表观扩散系数（ADC）值和体素内不相干运动（IVIM）参数值在不同磁共振成像（MRI）设备之间的一致性对患者的诊断和治疗有显著影响。
探讨胰腺检查中不同MRI设备之间图像质量、ADC值和IVIM参数值的一致性。
本回顾性研究经当地伦理委员会批准，并获得所有参与者的知情同意。共有22名年龄在24 - 61岁（平均28.9±2.3岁）的健康志愿者（10名男性和12名女性）使用来自三个供应商的3.0T MRI设备进行胰腺扩散加权成像。两名独立观察者对图像质量进行主观评分，并测量胰腺的整体ADC值和信噪比（SNR）。随后，使用后处理软件在胰腺的头部、体部和尾部划定感兴趣区域（ROI）以测量IVIM参数（真实扩散系数、伪扩散系数和灌注分数）。使用kappa一致性检验评估主观图像评分。使用组内相关系数（ICC）和混合线性模型评估每个设备的定量参数值。最后，使用Bland - Altman图对各设备之间的IVIM参数值进行成对分析。
不同观察者主观评分的Kappa值为0.776（<0.05）。定量参数的观察者间和观察者内一致性的ICC值分别为0.803 [95%置信区间（CI）：0.684 - 0.880]和0.883（95%CI：0.760 - 0.945）（<0.05）。不同设备之间SNR的ICC值具有可比性（>0.05），不同设备ADC值的ICC值分别为0.870、0.707和0.808（<0.05）。值得注意的是，不同IVIM参数仅观察到少数具有统计学意义的设备间一致性，且其中ICC值普遍较低。混合线性模型结果表明，使用不同MRI机器获得的胰腺头部、胰腺体部和胰腺尾部的-值存在差异（<0.05）。Bland - Altman图显示在一些数据点存在显著变异性。
不同设备之间ADC值具有一致性，但IVIM参数的可重复性中等。因此，IVIM参数值的变异性可能与使用不同的MRI机器有关。因此，在使用IVIM参数值评估胰腺时应谨慎。
