摘要
目的评估感兴趣区(ROI)不同设置方法对肝癌(HCC)患者TACE术治疗前后ADC值测量及观察者之间变异的影响。方法 36例经病理证实中晚期肝癌患者于肝动脉栓塞化疗(TACE)术前、术后1个月行扩散加权成像检查(b=1 000)。两位有经验的放射科医生通过三种不同ROI设置方法对肝癌病灶行ADC值测量,这三种方法分别为:整体容积法、最大层面法、多个小样本法,最后对不同ROI设置方法测量的平均ADC±SD值及观察者之间变异的差异用组内相关系数(ICC)进行对比分析。结果三种ROI设置方法在不同观察者间均存在较好的一致性(P>0.05,ICC=0.99)。整体容积法ROI的ICC在TACE术前非常好(0.91),在TACE术后良好(0.79),单层最大层面法在TACE术前、后的ICC分别为0.77和0.63,多个小样本法的ICC分别为0.76和0.37。多个小样本法TACE术前ADC值低于整体容积法或最大层面法。TACE术后的ADC值在整体容积、最大层面或多个小样本ROI间差异无统计学意义。整体容积和最大层面ROI的SD显著大于多个小样本ROI。结论 ROI设置大小和位置对肿瘤的ADC值测量和观察者间变异有相当大的影响。TACE术后观察者间变异性更大。整体容积法获得的肿瘤ADC值最具可重复性的结果。
Objective To assess the influence of region of interest（ROI）size and positioning on tumour ADC measurements and interobserver variability in patients with liver tumors before and after Transcatheter arterial chemoembolization（TACE）.Methods Thirty-six cases confirmed by pathology terminal-stage liver cancer patients were included.Patients underwent MRI including DWI（b =0,600,1000）before and one months after TACE.Two readers measured mean tumour ADCs（pre-and post-TACE）according to three ROI protocols：whole-volume,single-slice or small solid samples.The three protocols were compared for differences in ADC,SD and interobserver variability（measured as the intraclass correlation coefficient;ICC）.Results Three methods of ROI set there were good consistency between different observers（P〈0.05,ICC=0.99）.ICC for the whole-volume ROIs was excellent（0.91）pre-CRT versus good（0.79）post-CRT.ICCs were 0.77 and 0.63 for the single-slice ROIs versus 0.76 and 0.37 for the sample ROIs.Pre-CRT ADCs for the sample ROIs were significantly lower than for the whole-volume or single-slice ROIs.Post-CRT there were no significant differences between the whole-volume ROIs and the single-slice or sample ROIs,respectively.The SDs for the whole-volume and single-slice ROIs were significantly larger than for the sample ROIs.Conclusion ROI size and positioning have a considerable influence on tumour ADC values and interobserver variability.Interobserver variability is worse after TACE.ADCs obtained from the whole tumour volume provide the most reproducible results.
出处
《医学影像学杂志》
2015年第2期278-282,共5页
Journal of Medical Imaging
关键词
肝癌
扩散加权成像
表观扩散系数
感兴趣区
Hepatocellular carcinoma
Diffusion weighted imaging
Apparent diffusion coefficient
作者简介
作者简介：潘奇（1983-），男，山西运城人，在职博士，主治医师，主要从事腹部影像学诊断工作
通信作者：宦怡主任医师E-mail：huanyi3000@163．com
