摘要
目的探讨基于体素内不相干运动(intravoxel incoherent motion,IVIM)图像,利用三维容积ROI直方图分析方法,术前评估肝细胞癌(hepatocellular carcinoma,HCC)病理分化程度的价值。材料与方法回顾性分析术前行动态增强、DWI、IVIM检查且经病理证实的51例HCC患者(52个病灶),其中低分化组15个,非低分化组37个。在GE AW4.6工作站,对DWI、IVIM图进行后处理,获得ADC、D(Dmono)、D^*(D^*mono)及f(fmono)功能图,并对其进行传统ROI分析,结果记作cROI(conventional,ROI)。对ADC、D、D^*、f进行三维容积ROI直方图分析,直方图参数包括min、max、mean、std、range、skewness、kurtosis、quantile(5th^95th)。采用ICC检验两观察者测量结果的一致性;采用独立样本t检验或Mann-Whitney U检验比较各参数的差异。将有差异的直方图特征进行联合诊断。应用ROC曲线评价各参数的诊断效能,采用Delong检验比较各参数AUC值的差异。结果2名观察者对所有参数测量结果一致性良好(ICC>0.75);低分化HCC的ADCrange、Dstd/range高于非低分化HCC,而Dmin/mean/5th/10th/25th/50th、D^*min、fmin、DcROI低于非低分化组,差异有统计学意义(P<0.05)。将容积ROI直方图参数D5th、D10th、D50th、Drange联合后,AUC值提高,差异有统计学意义(P<0.05)。结论IVIM容积ROI直方图能够术前评估HCC病理分化程度,将直方图参数进行联合后,诊断效能有所提高。
Objective:To explore the value of three-dimensional volumetric ROI histogram of intravoxel incoherent motion(IVIM)in preoperatively evaluating pathological differentiation of hepatocellular carcinoma(HCC).Materials and Methods:We retrospectively analyzed 51 HCC patients(52 HCC lesions)confirmed by pathology,who preoperatively underwent liver acquistion with volume acceleration(LAVA)dynamic enhancement,DWI and IVIM scanning of MR.The HCC lesions were categorized as poorly differentiated group(15 lesions)and nonpoorly differentiated group(37 lesions)according to the pathological results.The DWI images were post-processed to obtain the apparent diffusion coefficient(ADC)images and the IVIM images were post-processed to obtain D(Dmono),D^*(D^*mono)and f(fmono)images on GE AW4.6 workstation.Conventional ROI analysis:using Functool software on GE AW 4.6 workstation,we drew three ROIs of the same area from the solid components of the largest layer of HCC on ADC,D,D^*and f images respectively.The average value of signal intensity of three ROIs was calculated and recorded as cROI(conventional ROI).Three-dimensional volumetric ROI histogram analysis:using Omni-Kinetics software,we drew the ROI along the edge of each layer of lesion on the ADC,D,D^*and f images,and then these ROIs were respectively merged into a volumetric ROI.The parameters of the volumetric ROI histogram were calculated,including min,max,mean,std,range,skewness,kurtosis and percentile quantile.ICC test was used to evaluate the consistency of two observers'measurements.Independent sample student's t tests or Mann-Whitney U test was used to compare the differences between the two groups of HCC.Combination diagnosis was made based on statistically significant histogram parameters.The ROC curves were made,followed by the diagnostic performance analysis and comparison between any two AUC values by using Delong test.Results:(1)The two observers'measurements were consistent(ICC>0.75).(2)The ADCrange and Dstd/range of poorly differentiated HCC were significantly higher than that of nonpoorly differentiated HCC(P<0.05).(3)Dmin/mean/5th/10th/25th/50th,D^*min,fmin and DcROI of poorly differentiated HCC were lower than that of non-poorly differentiated HCC.(4)After combining the volumetric ROI histogram parameters D5th,D10th,D50th and Drange,the AUC value increased,and the difference was statistically significant(P<0.05).Conclusions:The three-dimensional volumetric ROI histogram based on IVIM was helpful for preoperatively evaluating pathological differentiation of HCC.After combining histogram parameters,the diagnostic efficiency was improved.
作者
张喆
刘爱连
赵莹
郭妍
ZHANG Zhe;LIU Ailian;ZHAO Ying;GUO Yan(Department of Radiology,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China;GE Healthcare(Shanghai),Shanghai 200000,China)
出处
《磁共振成像》
CAS
2020年第9期758-764,770,共8页
Chinese Journal of Magnetic Resonance Imaging
基金
国家自然科学基金面上项目(编号:61971091)。
关键词
体素内不相干运动
癌
肝细胞
磁共振成像
intravoxel incoherent motion
carcinoma,hepatocellular
magnetic resonance imaging
作者简介
通信作者:刘爱连,E-mail:liuailian@dmu.edu.cn。
