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预测性体素内不相干运动扩散加权成像(IVIM-DWI)参数在乙型肝炎患者肝纤维化分期中的应用

Predictive intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters in the staging of fibrosis in hepatitis B patients.

作者信息

Emir Sevde Nur, Kulali Fatma, Tosun Ilkay, Bukte Yasar

机构信息

University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey.

出版信息

Pol J Radiol. 2025 Feb 7;90:e66-e73. doi: 10.5114/pjr/199686. eCollection 2025.

Abstract

PURPOSE

Our aim was to evaluate the diagnostic efficacy of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters [, , , and apparent diffusion coefficient (ADC) values] in the detection and staging of liver fibrosis in patients with hepatitis B virus (HBV).

MATERIAL AND METHODS

In this prospective study, a patient group of 64 consecutive patients (with a mean age of 43 years, 30 women and 34 men) with HBV, who scheduled liver biopsy, and a control group of 30 healthy individuals without liver disease underwent IVIM-DWI scan. A total of 94 IVIM-DWI examinations were analysed. IVIM-DWI parameters were measured in the right lobe of the liver. The IVIM-DWI parameters of the patient and control groups were compared by Mann-Whitney test. The patient group was classified into subgroups according to fibrosis stage of histopathological results. Receiver operating characteristic (ROC) analysis was conducted to assess the sensitivity and specificity of each parameter for detection and staging fibrosis.

RESULTS

and ADC values were significantly lower in the patient group compared to the control group ( < 0.05), while values were significantly higher ( < 0.05). No significant difference was observed in values between the 2 groups. had the highest diagnostic performance, with a sensitivity of 78.1% and specificity of 73.3%, with a cut-off value of 1.4 × 10 mm/s in the differentiation of fibrosis stages.

CONCLUSIONS

IVIM-DWI, particularly the , , and ADC parameters, is an adjunctive non-invasive alternative to biopsy in the staging of HBV-related liver fibrosis, especially for the prediction of advanced fibrosis.

摘要

目的

我们的目的是评估体素内不相干运动扩散加权成像(IVIM-DWI)参数[、、、及表观扩散系数(ADC)值]在乙型肝炎病毒(HBV)患者肝纤维化检测及分期中的诊断效能。

材料与方法

在这项前瞻性研究中,64例连续的计划进行肝活检的HBV患者(平均年龄43岁,30名女性和34名男性)组成的患者组以及30名无肝病的健康个体组成的对照组接受了IVIM-DWI扫描。共分析了94次IVIM-DWI检查。在肝脏右叶测量IVIM-DWI参数。采用Mann-Whitney检验比较患者组和对照组的IVIM-DWI参数。根据组织病理学结果的纤维化分期将患者组分为亚组。进行受试者工作特征(ROC)分析以评估各参数检测和分期纤维化的敏感性和特异性。

结果

与对照组相比,患者组的和ADC值显著降低(<0.05),而值显著升高(<0.05)。两组间值未观察到显著差异。在纤维化分期的鉴别中,具有最高的诊断性能,敏感性为78.1%,特异性为73.3%,临界值为1.4×10 mm/s。

结论

IVIM-DWI,尤其是、和ADC参数,是HBV相关肝纤维化分期中活检的辅助性非侵入性替代方法,特别是对于晚期纤维化的预测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f58f/11973707/fb922f656ad8/PJR-90-199686-g001.jpg

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