高效率的体内非相干运动扩散MRI检测病毒性肝炎b诱导的肝纤

StephenW

Ann Transl Med. 2019 Feb;7(3):39. doi: 10.21037/atm.2018.12.33.
High performance of intravoxel incoherent motion diffusion MRI in detecting viral hepatitis-b induced liver fibrosis.
Huang H1, Che-Nordin N2, Wang LF1, Xiao BH3, Chevallier O4, Yun YX1, Guo SW3, Wáng YXJ2.
Author information

1
    Department of Radiology, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen 518000, China.
2
    Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China.
3
    Department of Biomedical Engineering, South China University of Technology, Guangzhou 510000, China.
4
    Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, Université de Bourgogne, Dijon Cedex, France.

Abstract
Background:

Recently a small cohort study demonstrated that intravoxel incoherent motion (IVIM) diffusion MRI can detect early stage liver fibrosis. Using modified IVIM data acquisition parameters, the current study aims to confirm this finding.
Methods:

Twenty-six healthy volunteers, three patients of chronic viral hepatitis-b but without fibrosis and one mild liver steatosis subject, and 12 viral hepatitis-b patients with fibrosis (stage 1-2=7, stage 3-4=5) were included in this study. With a 1.5-T MR scanner and respiration-gating, IVIM diffusion imaging was acquired using a single-shot echo-planar sequence with a b-value series of 2, 0, 1, 15, 20, 30, 45, 50, 60, 80, 100, 200, 300, 600, 800 s/mm2. Signal measurement was performed on right liver parenchyma. The first three very low b-values were excluded to improve the curve fitting stability, and bi-exponential segmented fitting was performed using the 12 b-values of 15~800 s/mm2. Both threshold b-values of 60 s/mm2 and 200 s/mm2 were tested. With a 3-dimensional tool, Dslow (D), PF (f) and Dfast (D*) values were placed along the x-axis, y-axis, and z-axis, and a plane was defined to separate healthy volunteers from liver fibrosis patients.
Results:

Threshold b-value of 60 s/mm2 was preferred over 200 s/mm2 for separating healthy volunteers and liver fibrosis patients. The IVIM measures of the four patients without fibrosis resembled those of healthy volunteers. When threshold b-value =60 s/mm2 was applied, PF (PF <6.49%) could differentiate healthy livers and all fibrotic livers with 100% sensitivity and specificity. For the patients' measurement, PF and Dfast were highly correlated with a Pearson correlation coefficient r of 0.865 (P<0.001); while the correlations between slow diffusion compartment (Dslow) and fast diffusion compartment (Dfast or PF) were not statistically significant.
Conclusions:

This study confirms previous report that IVIM diffusion MRI has high diagnostic performance in detecting viral hepatitis-b induced liver fibrosis.
KEYWORDS:

Magnetic resonance imaging (MRI); diffusion; fibrosis. Viral hepatitis; intravoxel incoherent motion (IVIM); liver; perfusion

PMID:
    30906743
PMCID:
    PMC6389585
DOI:
    10.21037/atm.2018.12.33

StephenW

Ann Transl Med。 2019年2月; 7（3）：39。 doi：10.21037 / atm.2018.12.33。
高效率的体内非相干运动扩散MRI检测病毒性肝炎b诱导的肝纤维化。
Huang H1，Che-Nordin N2，Wang LF1，Xiao BH3，Chevallier O4，Yun YX1，Guo SW3，WángYXJ2。
作者信息

1
    南方科技大学第二附属医院深圳市第三人民医院放射科，深圳518000
2
    香港中文大学医学院影像及介入放射科，新界沙田威尔斯亲王医院，中国香港特别行政区。
3
    华南理工大学生物医学工程系，广州510000
4
    法国第戎Cedex法国勃艮第大学弗朗索瓦 - 密特朗教学医院血管和介入放射科

抽象
背景：

最近一项小型队列研究表明，体内非相干运动（IVIM）扩散MRI可以检测早期肝纤维化。使用修改的IVIM数据采集参数，目前的研究旨在证实这一发现。
方法：

26名健康志愿者，3名慢性病毒性肝炎患者，但没有纤维化和1名轻度肝脏脂肪变性患者，12名患有纤维化的病毒性乙型肝炎患者（1-2期= 7期，3-4期= 5期）被纳入在这个研究中。使用1.5-T MR扫描仪和呼吸门控，使用单次回波平面序列获得IVIM扩散成像，b值系列分别为2,0,1,15,20,30,45,50,60 ，80,100,200,300,600,800s / mm2。对右肝实质进行信号测量。排除前三个非常低的b值以改善曲线拟合稳定性，并且使用15~800s / mm 2的12个b值进行双指数分段拟合。测试了60s / mm 2和200s / mm 2的阈值b值。使用三维工具，沿x轴，y轴和z轴放置Dslow（D），PF（f）和Dfast（D *）值，并定义一个平面以将健康志愿者与肝纤维化患者。
结果：

对于分离健康志愿者和肝纤维化患者，阈值b值优选为60s / mm 2，超过200s / mm 2。 4例无纤维化患者的IVIM测量结果与健康志愿者相似。当应用阈值b值= 60s / mm2时，PF（PF <6.49％）可以区分健康肝脏和所有纤维化肝脏，具有100％的灵敏度和特异性。对于患者的测量，PF和Dfast高度相关，Pearson相关系数r为0.865（P <0.001）;而缓慢扩散区（Dslow）和快速扩散区（Dfast或PF）之间的相关性没有统计学意义。
结论：

该研究证实了之前的报道，IVIM扩散MRI在检测病毒性肝炎b诱导的肝纤维化方面具有很高的诊断性能。
关键词：

磁共振成像（MRI）;扩散;纤维化。病毒性肝炎;体内非相干运动（IVIM）;肝;灌注

结论：
    30906743
PMCID：
    PMC6389585
DOI：
    10.21037 / atm.2018.12.33