基于深度学习重建扩散加权成像图像评估甲状腺相关性眼病的活动性  

Deep learning-based reconstruction of diffusion-weighted imaging images to assess the activity of thyroid-associated ophthalmopathy

作　　者：王云梦 崔园园 倪双爽 代建昆 万欣怡 陈歆 姜沁伶 程宇欣 张天然 马宜传 萧毅 WANG Yunmeng;CUI Yuanyuan;NI Shuangshuang;DAI Jiankun;WAN Xinyi;CHEN Xin;JIANG Qinling;CHENG Yuxin;ZHANG Tianran;MA Yichuan;XIAO Yi(Graduate School of Bengbu Medical University,Bengbu 233000,China;Department of Radiology,Second Affiliated Hospital of Naval Medical University,Shanghai 200003,China;General Electric Healthcare Systems Trade Development(Shanghai)Company,Shanghai 200120,China;Department of Radiology,the First Affiliated Hospital of Bengbu Medical University,Bengbu 233000,China)

机构地区：[1]蚌埠医科大学研究生院,蚌埠233000 [2]海军军医大学第二附属医院放射科,上海200003 [3]通用电气医疗系统贸易发展(上海)有限公司,上海200120 [4]蚌埠医科大学第一附属医院放射科,蚌埠233000

出　　处：《磁共振成像》2024年第10期36-42,68,共8页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家重点研发计划项目(编号:2022YFC2410002);国家自然科学基金项目(编号:82271994);军队后勤保健课题项目(编号:22BJZ07)。

摘　　要：目的探讨深度学习重建(deep learning reconstruction,DLR)扩散加权成像(diffusion weighted imaging,DWI)图像在甲状腺相关性眼病(thyroid-associated ophthalmopathy,TAO)活动期与非活动期评估中的价值。材料与方法2023年4月至9月前瞻性纳入73例临床诊断为TAO的患者(活动期46例,非活动期27例)及26例健康对照组。所有受试者均使用3.0 T磁共振扫描仪和21通道头颈联合线圈进行眼眶MRI扫描。对视野优化无失真的单次激发成像和多路复用敏感度编码技术(field of view optimized and constrained undistorted single-shot imagingand multiplexed sensitivity encoding,FOCUS MUSE)的DWI序列进行传统重建(conventional reconstruction,ConR)和DLR。两名医师采用四分制评分量表独立对两种序列的图像质量进行主观评价。通过测量眼外肌的信噪比(signal-to-noise ratio,SNR)和对比噪声比(contrast-to-noise ratio,CNR)对图像质量进行客观评估。使用眼外肌的DWI表观扩散系数(apparent diffusion coefficient,ADC)值评估TAO的活动性。使用Wilcoxon检验比较ConR和DLRDWI间SNR、CNR和ADC值的差异。以临床活动度评分(Clinical ActivityScore,CAS)作为金标准,采用Kruskal-Wallis检验比较健康对照组、活动期组和非活动期组TAO患者的ADC值差异。使用受试者工作特征(receiver operating characteristic,ROC)曲线评价DLR DWI鉴别活动性TAO的性能,Spearman评估眼外肌的ADC值与CAS之间的相关性。结果DLR DWI在边界清晰度和整体图像质量上的主观评分显著高于ConR DWI,两序列的组内和组间一致性均达良好(Kappa>0.650)。和ConR相比,眼外肌DLR DWI的SNR和CNR显著提高(P<0.001)。ConR和DLR DWI的眼外肌ADC值差异无统计学意义(P>0.05)。在两种序列中,活动期组TAO患者眼外肌的ADC值均显著高于非活动期组TAO患者和健康对照组(P<0.001)。非活动期组TAO患者与健康对照组的ADC值差异均无统计学意义(P>0.05)。ConR DWI(r=0.637,P<0.001)和DLR DWI(r=0Objective:To investigate the value of deep learning reconstruction(DLR)orbital diffusion weighted imaging(DWI)images in the assessment of active and inactive stages of thyroid-associated ophthalmopathy(TAO).Materials and Methods:This prospectively study included 73 clinically diagnosed TAO patients(46 active TAO,27 inactive TAO)and 26 healthy controls from April to September 2023.All participants underwent orbital MRI scans using a 3.0 T MRI scanner and a 21ch head-and-neck combined coil.DWI sequences with field of view optimized and constrained undistorted single-shot imaging and multiplexed sensitivity encoding(FOCUS MUSE)were reconstructed by conventional reconstruction(ConR)and DLR.Two diagnostic radiologists independently subjectively evaluated the image quality of the two sequences using a four-point Likert scale.The image quality was objectively evaluated by measuring the signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of extraocular muscle(EOM).The DWI apparent diffusion coefficient(ADC)of EOM was used to distinguishing active from inactive TAO.The Wilcoxon was applied to test the difference of SNR,CNR,and ADC between ConR and DLR DWI,separately.Using the Clinical Activity Score(CAS)as the gold standard.The Kruskal-Wallis test was used to compare the difference of ADC between healthy controls,active and inactive TAO patients.Receiver operating characteristics(ROC)curves were used to compare the diagnostic performance of EOM ADC for differentiating active from inactive TAO patients between ConR and DLR DWI.The correlation between the EOM ADC and CAS of TAO patients was analyzed using Spearman's rank correlation coefficient.Results:DLR DWI had significantly higher subjective scores than ConR DWI for Sharpness of boundaries and overall image quality.The intra-and inter-reader agreement for both sequences was good(Kappa>0.650).Significantly higher SNR and CNR in EOM DLR DWI compared to ConR(all P<0.001).No significant difference of EOM ADC was observed between ConR and DLR DWI(P>0.05).In both sequen

关 键 词：甲状腺相关性眼病 眼外肌 扩散加权成像 深度学习重建 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R581.1[医药卫生—诊断学] R771.3[医药卫生—临床医学]