Diffusion-weighted MRI in evaluating liver fibrosis: A feasibility study in cirrhotic patients

被引：83

作者：

Girometti R. ^{[1
]}

Furlan A. ^{[1
]}

Bazzocchi M. ^{[1
]}

Soldano F. ^{[2
]}

Isola M. ^{[2
]}

Toniutto P. ^{[3
]}

Bitetto D. ^{[3
]}

Zuiani C. ^{[1
]}

机构：

[1] Institute of Radiology, Udine University, I-33100 Udine

[2] Institute of Medical Statistics, Department of Medical and Morphological Research, Udine University, I-33100 Udine

[3] Liver Transplantation Unit, DP MSC, University of Udine, I-33100 Udine, P.le S, Maria della Misericordia

来源：

La radiologia medica | 2007年 / 112卷 / 3期

关键词：

Diffusion magnetic resonance imaging; Fibrosis; Liver cirrhosis;

D O I：

10.1007/s11547-007-0149-1

中图分类号：

学科分类号：

摘要：

Purpose. 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. Results. 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 1.31.10-3mm 2/s. Positive predictive value (PPV), negative predictive value (NPV) and overall accuracy were 100%, 99.9% and 96.4%, respectively. Conclusions. 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. © 2007 Springer-Verlag Italia.

引用

页码：394 / 408

页数：14

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