Objectives To assess the efficacy of diffusion kurtosis imaging (DKI) and compare DKI-derived parameters with conventional diffusion-weighted imaging (DWI) for distinguishing hepatocellular carcinoma (HCC) from benign hepatic nodules including focal nodular hyperplasia (FNH), hemangioma, and hepatocellular adenoma (HCA). Materials and Methods 151 patients with 182 hepatic nodules (114 HCCs and 68 benign nodules including 33 FNHs, 29 hemangiomas, and 6 HCAs) were analyzed. Preoperative MRI examinations including DKI (b values: 0, 200, 500, 800, 1500, and 2000 sec/mm2) were performed, and kurtosis (K), diffusivity (D), and apparent diffusion coefficient (ADC) were calculated. The efficacy of DKI-derived parameters K, D, and ADC for distinguishing HCC from these benign nodules was analyzed. Results ROC (receiver operating characteristic curve) analysis showed the optimal cutoff values of ADC, D, and K for identification of these benign nodules, and HCCs were 1.295 (area under the curve (AUC): 0.826; sensitivity 80.6%; specificity 70.8%), 1.787 (AUC: 0.770; sensitivity 83.6%; specificity 59.6%), and 1.002 (AUC: 0.761; sensitivity 65.5%; specificity 79.0%), respectively. Statistically significant differences were found in ADC, D, and K values between groups of HCC-FNH and HCC-hemangioma (P < 0.05). There were significant differences in K and ADC values between groups of FNH-hemangioma and HCA-hemangioma (P < 0.05), respectively. Using logistic regression analysis, a regression equation was obtained: Logit(P)=-1.982X 1+1.385X 3+1.948(X 1: ADC; X 3: K), and odds ratios (OR) were 0.138 (95% confidence interval (CI): 0.052, 0.367), and 8.996 (95% CI: 0.970, 16.460), respectively. Conclusion Both ADC value and DKI-derived parameters K and D values have demonstrated a higher preoperative efficacy in distinguishing HCC from FNH, hemangioma, and HCA. No evidence was shown to suggest D or K value was superior to the ADC value.

中文翻译：

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扩散峰度MR成像与常规扩散加权成像从良性肝结节中区分出肝细胞癌。

目的评估扩散峰度成像（DKI）的疗效，并将DKI衍生参数与常规扩散加权成像（DWI）进行比较，以区分肝细胞癌（HCC）与良性肝结节，包括局灶性结节性增生（FNH），血管瘤和肝​​细胞癌腺瘤（HCA）。材料与方法分析了151例182个肝结节（114个HCC和68个良性结节，包括33个FNH，29个血管瘤和6个HCA）的患者。进行包括DKI（b值：0、200、500、800、1500和2000 sec / mm2）的术前MRI检查，并计算峰度（K），扩散率（D）和表观扩散系数（ADC）。分析了DKI衍生参数K，D和ADC区分HCC与这些良性结节的功效。结果ROC（接收器工作特性曲线）分析显示，ADC，D和K的最佳截止值可用于识别这些良性结节，HCC为1.295（曲线下面积（AUC）：0.826；灵敏度80.6％；特异性70.8％） ），1.787（AUC：0.770;敏感性83.6％;特异性59.6％）和1.002（AUC：0.761;敏感性65.5％;特异性79.0％）。在HCC-FNH和HCC血管瘤组之间的ADC，D和K值之间存在统计学差异（P <0.05）。FNH-血管瘤和HCA-血管瘤组之间的K和ADC值分别存在显着差异（P <0.05）。使用logistic回归分析，获得了回归方程：Logit（P）=-1.982X 1 + 1.385X 3 + 1.948（X 1：ADC; X 3：K），优势比（OR）为0.138（95％置信度）间隔（CI）：0.052、0.367），和8.996（95％CI：0.970、16.460）。结论ADC值和DKI衍生的参数K和D值均具有较高的术前鉴别HCC与FNH，血管瘤和HCA的功效。没有证据表明D或K值优于ADC值。