The clinical value of the apparent diffusion coefficient of liver magnetic resonance images in patients with liver fibrosis compared to healthy subjects

J Family Med Prim Care. 2018 Nov-Dec;7(6):1501-1505. doi: 10.4103/jfmpc.jfmpc_299_18.

Abstract

Background: Fibrotic tissue forms following chronic inflammation in the liver, which may progress over time to cirrhosis. Liver biopsy is the gold standard for the diagnosis of liver fibrosis, and there has been a considerable interest in developing noninvasive methods.

Objectives: In the present study, we evaluated the efficacy of the apparent diffusion coefficient (ADC) of the liver in the diagnosis and staging of liver fibrosis.

Patients and methods: This case-control study was conducted on 40 patients with chronic liver disease and 31 healthy controls who were subjected to diffusion-weighted magnetic resonance imaging (MRI). Diagnostic values for different stages of fibrosis were determined using receiver-operating characteristic (ROC) curves based on the sensitivity and specificity.

Results: Of 37 patients in the case group, 12 were males (32.4%) and 25 (67.5%) were females, whereas in the control group of 31 patients, 11 were males (35.5%) and 20 (64.5%) were females. In the ROC analysis, area under the curve separating stage one or lower fibrosis from stage two or greater fibrosis groups with a b-value of 600 s/mm2 was 0.893 (98% confidence interval (CI): 0.795-0.955), and that with a b-value of 1000 s/mm2 was 0.946 (98% CI: 0.813-0.946).

Conclusion: Our results are in line with the previous studies, which showed that liver ADC values could be considered as a method for the diagnosis and staging of liver fibrosis.

Keywords: Apparent diffusion coefficient; biopsy; diffusion; fibrotic tissue; liver.