Diffusion-weighted MRI in evaluating liver fibrosis: a feasibility study in cirrhotic patients
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This study was designed to establish whether the measurement of apparent diffusion coefficients (ADCs) is clinically accurate in diagnosing liver fibrosis in a selected series of cirrhotic patients.
Materials and methods.
Twenty-eight cirrhotic patients (mean age 58.1 years) with histologically proven liver fibrosis and 29 healthy controls (mean age 43.8 yeas) underwent liver diffusion-weighted magnetic resonance (MR) using a 1.5-Tesla (T) magnet equipped with a phased-array coil. Diffusion studies with parallel imaging [generalized autocalibrating partially parallel acquisitions (GRAPPA)] were performed within a single breath-hold using a single-shot spin-echo echo-planar sequence (TE 74 ms) using four b values: b=0, 150, 250 and 400 s/mm2. A unidirectional diffusion gradient was applied. ADCs were measured on ADC maps.
Mean ADC was significantly lower in cirrhotic livers than in controls (1.11±0.16 vs. 1.54±0.12.10-3mm2/s) (p<0.0001). Receiver operating characteristic (ROC) analysis showed an area under the curve (AUC) of 0.96 [confidence interval (CI) 95%:(0.87; 0.94)], demonstrating higher sensitivity and specificity (92.9% and 100%, respectively) for an ADC cutoff of 1.31.10-3mm2/s. Positive predictive value (PPV), negative predictive value (NPV) and overall accuracy were 100%, 99.9% and 96.4%, respectively.
Diffusion-weighted MRI is an accurate tool in evaluating advanced liver fibrosis if an optimised single-shot spinecho echo-planar sequence with maximum intermediate b value is used. The ADC threshold for liver fibrosis was 1.31.10-3mm2/s.
- Diffusion-weighted MRI in evaluating liver fibrosis: a feasibility study in cirrhotic patients
La radiologia medica
Volume 112, Issue 3 , pp 394-408
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- Liver cirrhosis
- Diffusion magnetic resonance imaging
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- Author Affiliations
- 1. Institute of Radiology, Udine University, Via Colugna 50, I-33100, Udine, Italy
- 2. Institute of Medical Statistics, Department of Medical and Morphological Research, Udine University, P.le Kolbe 3, I-33100, Udine, Italy
- 3. Liver Transplantation Unit. DP MSC, University of Udine, P.le S, Maria della Misericordia, I-33100, Udine, Italy