Comparison of IDEAL-IQ and IVIM-DWI for Differentiating between Alpha Fetoprotein-Negative Hepatocellular Carcinoma and Focal Nodular Hyperplasia

Background: To compare the differential diagnostic value of iterative decomposition of water and fat with the echo asymmetrical and least-squares estimation quantitation sequence (IDEAL-IQ) with that of intravoxel incoherent motion diffusion-weighted imaging (IVIM DWI) in differentiating between alpha fetoprotein (AFP)-negative hepatocellular carcinoma (HCC) and focal nodular hyperplasia (FNH). Materials and Methods: A total of 28 AFP-negative HCC cases and 15 FNH cases were scanned using the IDEAL-IQ and IVIM-DWI magnetic resonance imaging (MRI) protocols. Two radiologists independently assessed the fat fraction (FF) and the iron level surrogate (R2*) derived from the IDEAL-IQ images and the apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) derived from the IVIM-DWI images. The intraclass correlation coefficients (ICC) were estimated to evaluate the agreement repeatability between the two readers. The area under the curve (AUC) of a receiver operating characteristics curve was used to compare the diagnostic efficiency of the parameters extracted from the two techniques. Results: The lesions in the HCC group had significantly higher FF than the FNH group (8.284 ± 5.756 vs. 2.559 ± 1.247, P < 0.05). ADC and D values were lower in the HCC lesions when compared with the FNH lesions (1.310 ± 0.253 and 0.909 ± 0.192, respectively, vs. 1.624 ± 0.304 and 1.230 ± 0.314; ×10⁻³ mm² /s). The FF parameter had the highest AUC (0.923) followed by D (0.864) and ADC (0.854). Conclusions: FF derived from IDEAL-IQ, and ADC and D derived from IVIM-DWI were able to differentiate AFP-negative HCC from FNH. IDEAL-IQ showed better performance for the differentiation of FNH from HCC than the IVIM-DWI-derived parameters.     

基于体素内不相干运动模型的扩散加权成像定量参数对老年乳腺癌患者的诊断价值及其与肿瘤恶性程度的相关性

目的 探讨基于体素内不相干运动模型的扩散加权成像(IVIM-DWI)定量参数对老年乳腺癌的诊断价值及其与肿瘤恶性程度的相关性。方法 选择河北省4所医院2015年4月至2020年2月收治的102例老年乳腺癌患者为乳腺癌组,选择同期95例乳腺良性病变患者为对照组。分析IVIM-DWI定量参数对老年乳腺癌患者的诊断效能及其与乳腺癌恶性程度的相关性。采用SPSS 21.0统计软件进行数据分析。计量资料比较采用t检验。采用Pearson相关分析IVIM-DWI定量参数与组织标本中增殖基因(Notch1、CXCL1)、侵袭基因(FOXF1、NUAK1)及自噬基因(ATG4D、ATG2B)的相关性。结果 乳腺癌组表现扩散系数(ADC)值、真实扩散系数(D)值、灌注相关扩散系数(D*)值及自噬相关基因4D(ATG4D)、自噬相关基因2B(ATG2B)表达量均低于对照组;灌注分数(f)值及Notch1、CXCL1、FOXF1、NUAK1表达量高于对照组,差异均有统计学意义(P＜0.05)。Pearson相关分析显示,老年乳腺癌患者ADC值、D值、D*值、f值与组织标本中Notch1、CXCL1、FOXF1、NUAK1基因表达量呈正相关(P＜0.05),与组织标本中ATG4D、ATG2B表达量呈负相关(P＜0.05)。ROC曲线下D值的曲线下面积(AUC)最大,AUC为0.952,灵敏度为96.05%,特异度为85.38%。浸润性导管癌、组织学分级G₃、临床分期Ⅲ~Ⅳ期、有淋巴结转移的乳腺癌患者D值明显低于病理其他类型、组织学分级G₁₊₂、临床分期Ⅰ~Ⅱ期、无淋巴结转移的患者,差异有统计学意义(P＜0.05)。结论 老年乳腺癌患者IVIM-DWI定量参数值异于乳腺良性病变患者,且其参数变化与肿瘤恶性程度直接相关,可作为临床早期筛查与恶性程度评估的有效手段。     

体素内不相干运动扩散加权成像定量参数对前列腺癌的诊断及鉴别价值及其与PSA的相关性

目的:研究体素内不相干运动扩散加权成像(IVIM-DWI)定量参数对前列腺癌的诊断及鉴别价值,并探讨与PSA值间的相关性.方法:回顾分析病理证实的30例前列腺癌及30例前列腺增生患者磁共振资料.所有患者均行常规MRI和IVIM-DWI检查,IVIM-DWI采用10个b值(10、20、30、50、80、100、200、400、1 000、1 500 s/mm2),将不同b值DWI数据传入后处理工作站,通过双指数模型拟合算法计算出病变区纯水分子扩散系数D值及灌注分数f值.记录所有患者的PSA值.比较前列腺癌和前列腺增生组间D、f值及PSA值之间的差异,并分析各参数之间的相关性.结果:前列腺癌组的D值明显低于前列腺增生组,f值及PSA值明显高于前列腺增生组,差异均有统计学意义(P<0.01).D值和f值、D值和PSA值呈负相关,f值和PSA值呈正相关,其相关性均有统计学意义(P<0.05).结论:IVIM-DWI定量参数对前列腺癌的诊断及其与前列腺增生的鉴别具有较高的价值;D值与PSA值呈负相关,f值与PSA值呈正相关,三者结合可为前列腺癌的诊断及恶性程度评估提供一定参考信息.     

IVIM-DWI联合动态增强MRI对前列腺癌诊断及分级的评估价值

目的探究IVIM-DWI联合动态增强MRI对前列腺癌诊断及分级的评估价值。方法选取2017年3月至2018年4月我院泌尿外科收治的42例前列腺癌患者作为研究对象,同期38例良性前列腺增生患者作为对照组。两组患者均进行IVIM-DWI、DCE-MRI检查,经图像后处理得IVIM-DWI参数真实扩散系数(D)、伪扩散系数(D*)、灌注分数(f);DCE-MRI参数容量转移常数、速率常数、血管外细胞外间隙容积分数、血管空间容积分数。观察上述参数在前列腺癌及前列腺增生中表现,通过ROC曲线评价其诊断价值,同时按照前列腺癌Gleason评分进行分组,比价参数间差异。结果观察组Ktrans、Kep、Vp、D*值高于对照组,而Ve、D、f值明显低于对照组(P<0.05)。DCE-MRI、IVIM-DWI各项定量参数诊断效能最高为D、f值。肿瘤Gleason评分越高,Kep、f值呈先大后小,D值减小,D*值增大(P<0.05)。结论IVIM-DWI联合DCE-MRI有助于诊断前列腺癌与前列腺增生,且IVIM-DWI优于DCE-MRI,IVIM-DWI参数中D值降低、D*值升高、f值由大到小表示高级别前列腺癌。