Abstract
Purpose
To investigate and compare the diagnostic value of diffusion kurtosis imaging (DKI) with diffusion-weighted imaging (DWI) in assessing and quantifying hepatic fibrosis.
Methods
Thirty rats were divided into the control group (n = 6) and the fibrosis experimental groups (n = 6 per group) with CCl4 administration for 2, 4, 6, and 8 weeks. Liver fibrosis stage (S) and necroinflammatory activity grade (G) were histopathologically determined. DKI and DWI were performed; mean apparent diffusion (MD), mean kurtosis (MK), and apparent diffusion coefficient (ADC) values were calculated. DKI parameters were compared with ADC values according to G/S scores.
Results
Strong inverse correlations were found between the degree of fibrosis and both MD and ADC (r = −0.840 and r = −0.760), while only weak correlation existed in MK (r = 0.405). ROC analyses demonstrated the AUC in MD, MK, and ADC of 0.862, 0.684, 0.817 for identifying mild and severe fibrosis, and 0.757, 0.675, 0.733 for non-cirrhosis and cirrhosis, respectively. The degree of fibrosis was significantly correlated with α-smooth muscle actin (α-SMA) (P < 0.0001); α-SMA had strong inverse correlation with MD (r = −0.723), moderate inverse correlation with ADC (r = −0.613), and very weak correlation with MK (r = 0.175). Additionally, MD was strongly correlated with the necroinflammatory activity (r = −0.758), ADC was moderately correlated (r = −0.492), and MK was weakly correlated (r = 0.254).
Conclusion
DKI may provide added information and serve as a valuable tool for the characterization and surveillance of liver fibrosis in a non-invasive manner.
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This study was funded by the National Natural Science Foundation for Young Scientists of China (grant number 81601488), the Shanghai Sailing Program (grant number 16YF1410600), and the National Natural Science Foundation of China (grant number 81571661).
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The authors declare that they have no conflict of interest.
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All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. All procedures performed in studies involving animals were in accordance with the ethical standards of the institution or practice at which the studies were conducted.
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Sheng, R.F., Wang, H.Q., Yang, L. et al. Diffusion kurtosis imaging and diffusion-weighted imaging in assessment of liver fibrosis stage and necroinflammatory activity. Abdom Radiol 42, 1176–1182 (2017). https://doi.org/10.1007/s00261-016-0984-4
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DOI: https://doi.org/10.1007/s00261-016-0984-4