Article Abstract

High performance of intravoxel incoherent motion diffusion MRI in detecting viral hepatitis-b induced liver fibrosis

Authors: Hua Huang, Nazmi Che-Nordin, Li-Fei Wang, Ben-Heng Xiao, Olivier Chevallier, Yong-Xing Yun, Sheng-Wen Guo, Yì Xiáng J. Wáng


Background: Recently a small cohort study demonstrated that intravoxel incoherent motion (IVIM) diffusion MRI can detect early stage liver fibrosis. Using modified IVIM data acquisition parameters, the current study aims to confirm this finding.
Methods: Twenty-six healthy volunteers, three patients of chronic viral hepatitis-b but without fibrosis and one mild liver steatosis subject, and 12 viral hepatitis-b patients with fibrosis (stage 1–2=7, stage 3–4=5) were included in this study. With a 1.5-T MR scanner and respiration-gating, IVIM diffusion imaging was acquired using a single-shot echo-planar sequence with a b-value series of 2, 0, 1, 15, 20, 30, 45, 50, 60, 80, 100, 200, 300, 600, 800 s/mm2. Signal measurement was performed on right liver parenchyma. The first three very low b-values were excluded to improve the curve fitting stability, and bi-exponential segmented fitting was performed using the 12 b-values of 15~800 s/mm2. Both threshold b-values of 60 s/mm2 and 200 s/mm2 were tested. With a 3-dimensional tool, Dslow (D), PF (f) and Dfast (D*) values were placed along the x-axis, y-axis, and z-axis, and a plane was defined to separate healthy volunteers from liver fibrosis patients.
Results: Threshold b-value of 60 s/mm2 was preferred over 200 s/mm2 for separating healthy volunteers and liver fibrosis patients. The IVIM measures of the four patients without fibrosis resembled those of healthy volunteers. When threshold b-value =60 s/mm2 was applied, PF (PF <6.49%) could differentiate healthy livers and all fibrotic livers with 100% sensitivity and specificity. For the patients’ measurement, PF and Dfast were highly correlated with a Pearson correlation coefficient r of 0.865 (P<0.001); while the correlations between slow diffusion compartment (Dslow) and fast diffusion compartment (Dfast or PF) were not statistically significant.
Conclusions: This study confirms previous report that IVIM diffusion MRI has high diagnostic performance in detecting viral hepatitis-b induced liver fibrosis.