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Lin L, Chen M, Huang X, Song J, Ye X, Liu K, Han L, Yan Z, Zheng M, Liu X. Association between paravertebral muscle radiological parameter alterations and non-alcoholic fatty liver disease. Abdom Radiol (NY) 2024; 49:2250-2261. [PMID: 38801559 DOI: 10.1007/s00261-024-04352-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE To assess changes in laboratory indices, paravertebral muscle (PVM) fat infiltration and multi b-value DWI parameters and their potential correlation with NAFLD. METHODS This retrospective analysis included 178 patients with histopathologically confirmed NAFLD, incluiding 76 with non-alcoholic steatohepatitis (NASH). Differences in PVM fat infiltration ratio (FIR), DWI parameters, and laboratory indices were compared between two groups. The correlation between FIR and NAFLD activity score (NAS) was also analysed. Binary logistic regression was used to identify the independent risk factors for NASH. The clinical utility of PVM fat infiltration, DWI parameters, and laboratory indices for diagnosing NASH in patients with NAFLD was evaluated using receiver operating characteristic (ROC) curves. RESULTS The FIRs at the L2 and L3 levels were significantly higher in the with NASH group than those in the without NASH group. The heterogeneity index (α) and perfusion fraction (f) values at the L3 level of PVM were lower in the with NASH group. Moreover, the FIR at the L3 level was positively correlated with NAS. FIR at the L3 level was an independent risk factor for NASH along with alanine aminotransferase level. The area under the ROC curve (AUC) using L3 level PVM radiological parameters and laboratory indices for diagnosing NASH in patients with NAFLD was significantly higher than that using the degree of PVM fat infiltration, DWI parameters, or laboratory indices alone. CONCLUSIONS Radiological parameters of the PVM were correlated with NAFLD. An integrated curve combining PVM radiological parameters may help distinguish NASH from NAFLD, thereby offering novel insights into the diagnosis of NASH.
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Affiliation(s)
- Lulu Lin
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Mengjiao Chen
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaoyan Huang
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jiawen Song
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xinjian Ye
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Kun Liu
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lu Han
- Philips Healthcare, Shanghai, China
| | - Zhihan Yan
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Minghua Zheng
- NAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
| | - Xiaozheng Liu
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
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Wen D, Peng P, Yue X, Xu C, Pu Q, Ming Y, Yang H, Zhang M, Ren Y, Sun J. Comparative study of stretched-exponential and kurtosis models of diffusion-weighted imaging in renal assessment to distinguish patients with primary aldosteronism from healthy controls. PLoS One 2024; 19:e0298207. [PMID: 38330049 PMCID: PMC10852313 DOI: 10.1371/journal.pone.0298207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/20/2024] [Indexed: 02/10/2024] Open
Abstract
PURPOSE To compare the ability of diffusion parameters obtained by stretched-exponential and kurtosis models of diffusion-weighted imaging (DWI) to distinguish between patients with primary aldosteronism (PA) and healthy controls (HCs) in renal assessment. MATERIALS AND METHODS A total of 44 participants (22 patients and 22 HCs) underwent renal MRI with an 11 b-value DWI sequence and a 3 b-value diffusion kurtosis imaging (DKI) sequence from June 2021 to April 2022. Binary logistic regression was used to construct regression models combining different diffusion parameters. Receiver-operating characteristic (ROC) curve analysis and comparisons were used to evaluate the ability of single diffusion parameters and combined diffusion models to distinguish between the two groups. RESULTS A total of six diffusion parameters (including the cortical anomalous exponent term [α_Cortex], medullary fractional anisotropy [FA_Medulla], cortical FA [FA_Cortex], cortical axial diffusivity [Da_Cortex], medullary mean diffusivity [MD_Medulla] and medullary radial diffusivity [Dr_Medulla]) were included, and 10 regression models were studied. The area under the curve (AUC) of Dr_Medulla was 0.855, comparable to that of FA_Cortex and FA_Medulla and significantly higher than that of α_Cortex, Da_Cortex and MD_Medulla. The AUC of the Model_all parameters was 0.967, comparable to that of Model_FA (0.946) and Model_DKI (0.966) and significantly higher than that of the other models. The sensitivity and specificity of Model_all parameters were 87.2% and 95%, respectively. CONCLUSION The Model_all parameters, Model_FA and Model_DKI were valid for differentiating between PA patients and HCs with similar differentiation efficacy and were superior to single diffusion parameters and other models.
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Affiliation(s)
- Deying Wen
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Pengfei Peng
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xun Yue
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Chenxiao Xu
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Pu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yue Ming
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Huiyi Yang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | | | - Yan Ren
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Jiayu Sun
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
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Zhang Z, Zha T, Jiang Z, Pan L, Liu Y, Dong C, Chen J, Xing W. Using Ultrahigh b -Value Diffusion-Weighted Imaging to Noninvasively Assess Renal Fibrosis in a Rabbit Model of Renal Artery Stenosis. J Comput Assist Tomogr 2023; 47:713-720. [PMID: 37707400 DOI: 10.1097/rct.0000000000001487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study aimed to investigate the feasibility of diffusion-weighted imaging with ultrahigh b values ( ub DWI) for the evaluation of renal fibrosis (RF) induced by renal artery stenosis (RAS) in a rabbit model. METHODS Thirty-two rabbits underwent left RAS operation, whereas 8 rabbits received sham surgery. All rabbits underwent ub DWI ( b = 0-4500 s/mm 2 ). The standard apparent diffusion coefficient (ADC st ), molecular diffusion coefficient ( D ), perfusion fraction ( f ), perfusion-related diffusion coefficient ( D *) and ultrahigh apparent diffusion coefficient (ADC uh ) were longitudinally assessed before operation and at weeks 2, 4, and 6 after operation. The degree of interstitial fibrosis and the expression of aquaporin (AQP) 1 and AQP2 were determined through pathological examination. RESULTS In the stenotic kidney, the ADC st , D , f , and ADC uh values of the renal parenchyma significantly decreased compared with those at baseline (all P < 0.05), whereas the D * values significantly increased after RAS induction ( P < 0.05). The ADC st , D , D *, and f were weakly to moderately correlated with interstitial fibrosis as well as with the expression of AQP1 and AQP2. Furthermore, the ADC uh negatively correlated with interstitial fibrosis ( ρ = -0.782, P < 0.001) and positively correlated with AQP1 and AQP2 expression ( ρ = 0.794, P < 0.001, and ρ = 0.789, P < 0.001, respectively). CONCLUSIONS Diffusion-weighted imaging with ultrahigh b values shows the potential for noninvasive assessment of the progression of RF in rabbits with unilateral RAS. The ADC uh derived from ub DWI could reflect the expression of AQPs in RF.
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Affiliation(s)
| | - Tingting Zha
- From the Department of Radiology, The Third Affiliated Hospital of Soochow University, Changzhou
| | - Zhenxing Jiang
- From the Department of Radiology, The Third Affiliated Hospital of Soochow University, Changzhou
| | - Liang Pan
- From the Department of Radiology, The Third Affiliated Hospital of Soochow University, Changzhou
| | - Yang Liu
- Department of Radiology, Yancheng Third People's Hospital, Yancheng, China
| | - Congsong Dong
- Department of Radiology, Yancheng Third People's Hospital, Yancheng, China
| | - Jie Chen
- From the Department of Radiology, The Third Affiliated Hospital of Soochow University, Changzhou
| | - Wei Xing
- From the Department of Radiology, The Third Affiliated Hospital of Soochow University, Changzhou
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Sheng R, Zhang Y, Sun W, Ji Y, Zeng M, Yao X, Dai Y. Staging Chronic Hepatitis B Related Liver Fibrosis with a Fractional Order Calculus Diffusion Model. Acad Radiol 2022; 29:951-963. [PMID: 34429260 DOI: 10.1016/j.acra.2021.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 12/17/2022]
Abstract
RATIONALE AND OBJECTIVES Accurately staging liver fibrosis is of great clinical significance. We aimed to evaluate the clinical potential of the non-Gaussian fractional order calculus (FROC) diffusion model in staging liver fibrosis. MATERIALS AND METHODS A total of 82 patients with chronic hepatitis B (CHB) were included in this prospective study. Diffusion weighted imaging (DWI)-derived parameters including the diffusion coefficient (D), fractional order parameter (β) and microstructural quantity (μ) sourced from FROC-DWI, and apparent diffusion coefficient (ADC) derived from mono-exponential DWI, as well as the aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 (FIB-4) were calculated. Their correlations with fibrosis stages and the diagnostic efficacy in predicting liver fibrosis were assessed and compared. RESULTS D (r = -0.667), β (r = -0.671), μ (r = -0.481), and ADC (r = -0.665) displayed significant correlations with fibrosis stages (p < 0.001). D, β and ADC (p < 0.01) were independently associated with fibrosis; and compared to inflammatory activity, fibrosis was the independent factor significantly correlated with D, β and ADC (p < 0.001). There were no significant differences between the area under curves of D, β, μ or their combinations and ADC for predicting different fibrosis stages (p > 0.05). The diagnostic performance of the combined index with four diffusion metrics was better than D, β, μ or ADC used alone (p < 0.05) as well as APRI or FIB-4 (p < 0.01) in fibrosis staging. CONCLUSION FROC-DWI was valuable in staging liver fibrosis in patients with CHB, but there were no significant differences between the FROC-DWI parameters and the classical ADC. However, the combined DWI-derived index including D, β, μ and ADC offered the best diagnostic efficacy and may serve as a reliable tool for fibrosis evaluation, superior to APRI and FIB-4.
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Affiliation(s)
- Ruofan Sheng
- Department of Radiology, Zhongshan Hospital, Fudan University; Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai, China
| | - Yunfei Zhang
- Central Research Institute, United Imaging Healthcare, Shanghai, China
| | - Wei Sun
- Department of Radiology, Zhongshan Hospital, Fudan University; Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai, China
| | - Yuan Ji
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University; Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai, China.
| | - Xiuzhong Yao
- Department of Radiology, Zhongshan Hospital, Fudan University; Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai, China
| | - Yongming Dai
- Central Research Institute, United Imaging Healthcare, Shanghai, China
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