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Diffusion-Weighted MRI for Quantification of Liver Fibrosis: Preliminary Experience

¹ New York University Medical Center, MRI, 530 First Ave., New York, NY 10016.
² Department of Pathology, New York University Medical Center, New York, NY.
³ Department of Pharmacology, New York University Medical Center, New York, NY.
⁴ Department of Medicine, Division of Hepatology, New York University Medical Center, New York, NY.

View larger version (88K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —46-year-old man with chronic hepatitis C virus cirrhosis (fibrosis stage 4 on liver biopsy). Breath-hold axial single-shot echo-planar diffusion-weighted images obtained with increasing b values show large amount of ascites. Calculated hepatic apparent diffusion coefficient was 1.06 ± 0.10 x10–3 mm2/s. Breath-hold axial single-shot echo-planar diffusion-weighted MR image obtained at b value of 300 s/mm2 shows placement of regions of interest in liver parenchyma.

View larger version (95K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —46-year-old man with chronic hepatitis C virus cirrhosis (fibrosis stage 4 on liver biopsy). Breath-hold axial single-shot echo-planar diffusion-weighted images obtained with increasing b values show large amount of ascites. Calculated hepatic apparent diffusion coefficient was 1.06 ± 0.10 x10–3 mm2/s. b = 0 s/mm2, 50 s/mm2

View larger version (91K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1C —46-year-old man with chronic hepatitis C virus cirrhosis (fibrosis stage 4 on liver biopsy). Breath-hold axial single-shot echo-planar diffusion-weighted images obtained with increasing b values show large amount of ascites. Calculated hepatic apparent diffusion coefficient was 1.06 ± 0.10 x10–3 mm2/s. b = 0 s/mm2, 300 s/mm2

View larger version (79K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1D —46-year-old man with chronic hepatitis C virus cirrhosis (fibrosis stage 4 on liver biopsy). Breath-hold axial single-shot echo-planar diffusion-weighted images obtained with increasing b values show large amount of ascites. Calculated hepatic apparent diffusion coefficient was 1.06 ± 0.10 x10–3 mm2/s. b = 0 s/mm2, 500 s/mm2

View larger version (75K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1E —46-year-old man with chronic hepatitis C virus cirrhosis (fibrosis stage 4 on liver biopsy). Breath-hold axial single-shot echo-planar diffusion-weighted images obtained with increasing b values show large amount of ascites. Calculated hepatic apparent diffusion coefficient was 1.06±0.10x10–3 mm2/s. b = 0 s/mm2, 700 s/mm2

View larger version (68K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1F —46-year-old man with chronic hepatitis C virus cirrhosis (fibrosis stage 4 on liver biopsy). Breath-hold axial single-shot echo-planar diffusion-weighted images obtained with increasing b values show large amount of ascites. Calculated hepatic apparent diffusion coefficient was 1.06±0.10x10–3 mm2/s. b = 0 s/mm2, 1,000 s/mm2

View larger version (72K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1G —46-year-old man with chronic hepatitis C virus cirrhosis (fibrosis stage 4 on liver biopsy). Breath-hold axial single-shot echo-planar diffusion-weighted images obtained with increasing b values show large amount of ascites. Calculated hepatic apparent diffusion coefficient was 1.06±0.10x10–3 mm2/s. b = 0 s/mm2

View larger version (118K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1H —46-year-old man with chronic hepatitis C virus cirrhosis (fibrosis stage 4 on liver biopsy). Breath-hold axial single-shot echo-planar diffusion-weighted images obtained with increasing b values show large amount of ascites. Calculated hepatic apparent diffusion coefficient was 1.06±0.10x10–3 mm2/s. Apparent diffusion coefficient map obtained with all b values.

View larger version (8K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2 —Receiver operating characteristics curve with apparent diffusion coefficient for prediction of stage 2 or greater hepatic fibrosis with combination of all b values (0, 50, 300, 500, 700, and 1,000 s/mm2). Area under curve is 0.896 with sensitivity of 83.3% and specificity of 83.3%.

View larger version (8K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3 —Receiver operating characteristics curve with apparent diffusion coefficient for prediction of stage 3 or greater hepatic fibrosis with combination of all b values (0, 50, 300, 500, 700, and 1,000 s/mm2). Area under curve is 0.896 with sensitivity of 88.9% and specificity of 80.0%.

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