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. 2015;24(6):522-6.
doi: 10.1159/000434682. Epub 2015 Jul 16.

Assessment of Liver Fibrosis with Diffusion-Weighted Magnetic Resonance Imaging Using Different b-values in Chronic Viral Hepatitis

Ercan Kocakoc  1 , Ayse Ahsen Bakan, Orhan Kursat Poyrazoglu, Adile Ferda Dagli, Yeliz Gul, Mehtap Cicekci, Ibrahim Halil Bahcecioglu
Affiliations

Assessment of Liver Fibrosis with Diffusion-Weighted Magnetic Resonance Imaging Using Different b-values in Chronic Viral Hepatitis

Ercan Kocakoc et al. Med Princ Pract. 2015.

Abstract

Objective: To examine the effectiveness of apparent diffusion coefficient (ADC) values and to compare the reliability of different b-values in detecting and identifying significant liver fibrosis.

Subjects and methods: There were 44 patients with chronic viral hepatitis (CVH) in the study group and 30 healthy participants in the control group. Diffusion-weighted magnetic resonance imaging (DWI) was performed before the liver biopsy in patients with CVH. The values of ADC were measured with 3 different b-values (100, 600, 1,000 s/mm2). In addition, liver fibrosis was classified using the modified Ishak scoring system. Liver fibrosis stages and ADC values were compared using areas under the receiver-operating characteristic (ROC) curve.

Results: The study group's mean ADC value was not statistically significantly different from the control group's mean ADC value at b = 100 s/mm2 (3.69 ± 0.5 × 10-3 vs. 3.7 ± 0.3 × 10-3 mm2/s) and b = 600 s/mm2 (2.40 ± 0.3 × 10-3 vs. 2.5 ± 0.5 × 10-3 mm2/s). However, the study group's mean ADC value (0.99 ± 0.3 × 10-3 mm2/s) was significantly lower than that of the control group (1.2 ± 0.1 × 10-3 mm2/s) at b = 1,000 s/mm2. With b = 1,000 s/mm2 and the cutoff ADC value of 0.0011 mm2/s for the diagnosis of liver fibrosis, the mean area under the ROC curve was 0.702 ± 0.07 (p = 0.0015). For b = 1,000 s/mm2 and the cutoff ADC value of 0.0011 mm2/s to diagnose significant liver fibrosis (Ishak score = 3), the mean area under the ROC curve was 0.759 ± 0.07 (p = 0.0001).

Conclusion: Measurement of ADC values by DWI was effective in detecting liver fibrosis and accurately identifying significant liver fibrosis when a b-value of 1,000 s/mm2 was used.

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Figures

Fig. 1
Fig. 1
Gray-scale ADC map for patient A from the study group. ADC values for the 3 ROIs at a b-value of 100 s/mm2 were as follows: 3.26 × 10−3, 3.61 × 10−3 and 3.83 × 10−3 mm2/s.
Fig. 2
Fig. 2
Gray-scale ADC map for patient A from the study group. ADC values for the 3 ROIs at a b-value of 600 s/mm2 were as follows: 2.60 × 10−3, 2.34 × 10−3 and 2.05 × 10−3 mm2/s.
Fig. 3
Fig. 3
Gray-scale ADC map for patient A from the study group. ADC values for the 3 ROIs at a b-value of 1,000 s/mm2 were as follows: 1.48 × 10−3, 1.38 × 10−3 and 1.36 × 10−3 mm2/s.
Fig. 4
Fig. 4
ROC curve analysis of ADC values for detecting liver fibrosis at a b- value of 1,000 s/mm2 and for ADC ≤1.1 × 10−3 mm2/s.
Fig. 5
Fig. 5
ROC curve analysis of ADC values for detecting Ishak score ≥3 liver fibrosis at a b- value of 1,000 s/mm2 and for ADC ≤1.1 × 10−3 mm2/s.
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