Intravoxel incoherent motion imaging for diagnosing and staging the liver fibrosis and inflammation

• Published in: Abdominal imaging 2020-01, Vol.45 (1), p.15-23
• Main Authors: Tosun, Mesude, Onal, Tugay, Uslu, Hande, Alparslan, Burcu, Çetin Akhan, Sıla
• Format: Article
• Language: English
• Subjects: Adult; Biopsy; Diagnostic systems; Diffusion; Diffusion coefficient; Evaluation; Female; Fibrosis; Gastroenterology; Hepatitis; Hepatitis B; Hepatitis B, Chronic - complications; Hepatobiliary; Hepatology; Humans; Image Interpretation, Computer-Assisted - methods; Imaging; Inflammation; Inflammation - diagnostic imaging; Inflammation - etiology; Interferon; Liver; Liver - diagnostic imaging; Liver Cirrhosis - diagnostic imaging; Liver Cirrhosis - etiology; Liver diseases; Liver Diseases - diagnostic imaging; Liver Diseases - etiology; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medical diagnosis; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Model accuracy; Parameter modification; Perfusion; Radiology; Reproducibility of Results; Retrospective Studies; Severity of Illness Index
• ISSN: 2366-004X; 2366-0058
• DOI: 10.1007/s00261-019-02300-z

Purpose To evaluate the diagnostic accuracy of intravoxel incoherent motion (IVIM) model parameters for the diagnosis and staging of liver fibrosis and inflammation in patients with chronic hepatitis B. Methods Fifty-four patients with chronic hepatitis B and 42 healthy volunteers were included in the study. All subjects were examined by 3 T magnetic resonance imaging. Diffusion-weighted imaging was undertaken with sixteen b values. IVIM parameters [ D (true diffusion coefficient), D* (pseudo-diffusion coefficient), f (perfusion fraction)] were calculated. Histological evaluation of biopsy samples was considered the reference standard for the staging of liver fibrosis and inflammation. Differences in IVIM parameters between patient and control groups were analyzed. In the patient group, fibrosis stage and inflammation grade groups were analyzed with respect to IVIM parameters. The correlation was assessed between IVIM parameters and Ishak-modified scale of fibrosis stages and inflammation grades. Results The D was significantly lower in the patient group than the control group, p  = 0.038 with Cohen’s d effect size of 0.452. D was significantly different between fibrosis stage levels. D values decreased in fibrosis stages from the minimal to moderate to marked fibrosis. Fibrosis grades significantly negatively correlated with D and D* values, p  = 0.001, and 0.021, respectively. In addition, inflammation grades negatively correlated with f values, p  = 0.047. Conclusion D values measured with IVIM imaging may help to diagnose liver fibrosis. IVIM imaging could be an alternative to liver biopsy for the staging of liver fibrosis.