COMPARISON OF THE EFFICIENCY OF CONVENTIONAL DIFFUSION, DIFFUSION TENSOR IMAGING, AND DYNAMIC SUSCEPTIBILITY CONTRAST-ENHANCED MAGNETIC RESONANCE PERFUSION IMAGING IN THE EVALUATION OF LIVER FIBROSIS

Abstract

Objective: Liver fibrosis is a dynamic, reversible process that can result in liver failure. There has been considerable interest in developing noninvasivemethods for diagnosis and staging. To investigate the diffusion and perfusion changes of the fibrotic liver parenchyma with conventional diffusion-weightedimaging (CDI), diffusion tensor imaging (DTI), and T2*weighted dynamic susceptibility contrast-magnetic resonance perfusion imaging (DSC-MRPI) at3Tesla MR scanner.Methods: Twenty-seven patients with chronic viral hepatitis and 24 volunteers were evaluated, prospectively. The standard MRI protocols of the abdomen,CDI, and DTI were performed. Apparent diffusion coefficient (ADC) maps were obtained, D and FA values were calculated for DTI. Signal Intensity(SI)-time curves were obtained and “blood volume”(BV), “blood flow” (BF), “time to peak”(TTP), “mean transit time”(MTT) were measured. All patients withhepatitis underwent liver biopsy. The efficacy of diffusion and perfusion parameters used in the diagnosis of fibrosis was analyzed with the receiver operatingcharacteristic curve (ROC).Results: Patients had significantly lower liver ADC when compared to the control group, either with CDI and DTI. D values obtained from DTI were lowerin patients than those of the normal volunteers, and the difference was statistically significant. On DSC-MRPI; BF, BV, MTT, and TTP of the liver werelower than those of the control group but only BV and MTT values showed statistical significance. Liver ADC, D, and BV values had a negative correlationwith fibrosis.Conclusion: The results showed that the D values obtained from DTI, BV, and MTT values obtained from DSC-MRPI can be an efficient diagnostic tool forliver fibrosis in patients with chronic hepatitis.