Diagnosis of hepatic fibrosis with MR diffusion weighted imaging:preliminary results

Objective To choose a noninvasive method for assessing hepatic fibrosis reasonablely in our clinical study, and compared with histopathology, the changes of ADC value and blood biochemiology in patients were analyzed. Methods 41 patients of hepatic fibrosis who received liver biopsy and 10 healthy volunteers were included in this study. All of them underwent DWI on 1.5T MRI device. Apparent diffusion coef- ficient (ADC) of liver were measured when b value were set as 600s/mm2. Blood samples were obtained in all patients to observe blood biochemiology of hepatic fibrosis including hyaluronic acid(HA), and Forns index, APRI index. Statistical analysis was performed by SPSS 16.0 for windows statistical software, P 0.05 was considered statistically significance. Results 1.ADC values decreased gradually as the stage of fibrosis progressed(P 0.01). When b value was 600s/mm2, ADC values have statistically significance(P0.05) except only between S0 and S1. There was a good negative corre- lation between ADC values and stages of fibrosis. 2. The ADC values and the blood biochemiology indices were all of certain value in diagnosis hepatic fibrosis with the AUC 0.7. In discriminating patients staged S≥2, the areas under the receiver operat- ing characteristic curves(AUC) were 0.88 for ADC, the sensitivity, the specificity were 75.9%, 83.3%, respectively; In discriminating patients staged S ≥ 3, the areas under the receiver operating characteristic curves(AUC) were 0.93 for ADC, the sensitivity, the specificity were 86.7%, 88.5%, respectively. Not only when S ≥ 2 but also S ≥ 3 for one with hepatic fibrosis was arbitrarily defined, the AUC of ADC values were larger than blood biochemiology indices. Conclusion DWI was an effective method to quantify severity hepatic fibrosis as well as to detect moderate-severe fibrosis and early cirrhosis.