肝脏恶性肿瘤ADC值测量的可重复性及可重现性研究  

Repeatability and reproducibility of the apparent diffusion coefficient values of primary and metastatic hepatic carcinomas on MR diffusion-weighted imaging

作　　者：何健[1] 李丹燕[1] 朱斌[1] 章士正[2] 周正扬[1] 

机构地区：[1]南京大学医学院附属鼓楼医院医学影像科,南京210008 [2]浙江大学医学院附属邵逸夫医院放射科,浙江310016

出　　处：《放射学实践》2013年第2期168-172,共5页Radiologic Practice

基　　金：南京市医学科技发展青年资助项目(yqk11159);南京市卫生青年人才培养工程第三层次

摘　　要：目的:评价肝脏恶性肿瘤ADC值测量的观察者内及观察者间一致性,病灶ADC值测量的可重复性及可重现性。方法:对15例患者(男11例,女4例,平均年龄62岁,共30个肝脏原发及转移性肿瘤)在第一次MRI检查中重复进行2次DWI扫描,于次日机器重启后再次行DWI扫描(b值均为500s/mm2)。两位放射科医师分别独立测量病灶ADC值,同一观察者对同一DWI序列相隔一天进行两次测量并记录ADC值,对第一次检查中两次DWI序列分别进行测量并记录ADC值,对两次检查的DWI序列分别测量并记录ADC值。采用SPSS 13.0软件中可靠性检验及Bland-Alt-man分析评估观察者内、观察者间一致性以及ADC值测量的可重复性及可重现性。结果:同一观察者两次测量同一DWI序列(观察者内),两位观察者分别测量同一DWI序列(观察者间),同次检查中两个DWI序列(可重复性),两次检查中两个DWI序列(可重现性)测得病灶ADC值,采用可靠性检验得出组内相关系数(ICC)分别为0.997,0.991,0.857,0.827,变异系数分别为1.75%,2.86%,9.88%和9.55%;Bland-Altman分析发现观察者内、观察者间和可重复性检验所有点均位于一致性界限之内,可重现性分析中发现有6.7%(2/30)的点位于一致性界限之外。结论:肝脏恶性肿瘤ADC值测量的观察者内及观察者间一致性,短期可重复性较好,但变异率小于18.72%的ADC值改变可能是由于测量误差引起的,同时需要注意可重现性的误差控制。Objective：To evaluate the intra and inter-observer consistency,short-term repeatability and reproducibility of the measurement of apparent diffusion coefficient （ADC） values of hepatic malignant lesions. Methods：Fifteen patients （11 male,4 female,average age 62 years,with 30 primary and metastatic hepatic carcinomas） underwent the first MR exam session including two diffusion weighted imaging （DWI） scans and the second session of a third DWI scan （b 500s/mmz） in the next day after restart of the MR scanner. Two radiologists measured the ADC values of the lesions independantly. AI）C values of the same DWI sequence was measured twice with an interval of one day by one observer. ADC values of two DWI sequences in the first session were measured. ADC values of two DWI sequences in different sessions were also meas- ured. The intra- and interobserver consistency,short term repeatability and reproducibility of the measurement of ADC val ues of hepatic malignant lesions were evaluated by using reliability test and Bland-Altman analysis in SPSS 13.0 software. Results： Intraclass correlation coefficients of the reliability test was 0. 997,0. 991,0. 857 and 0. 827, and the average coeffi cient of variation was 1. 75%,2.86%,9. 88% and 9. 55% in the intra and inter-observer consistency, the repeatability （two sequences both with a b value of 500s/mm2 lesion in the same session） and the reproducibility （two sequences both with a b value of 500s/mme in two sessions） evaluation respectively. Bland Altman analysis showed that all the data points from the intra and inter- observer consistency,as well as repeatability tests were located within the limits of consistency, while 6.7 % （2/30） points of reproducibility analysis located beyond the reference lines. Conclusions： Intra- and inter-observ er consistency and the short-term repeatability of the ADC values measurement are satisfied. A variation rate of the ADC value less than 18.72 % may be due to measurement error and attention should be p

关 键 词：肝肿瘤 表观扩散系数 可重复性 可重现性 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]