Diagnostic and prognostic value of a diffusion-weighted image of the liver with magnetic resonance imaging in patients with alcoholic liver disease

Abstract

The aim of the study was to assess the diagnostic and prognostic value of a diffusion-weighted image of the liver with magnetic resonance imaging in patients with alcoholic liver disease.Material and methods. A total of 113 patients with alcoholic liver disease (ALD) were examined. Among them, 65 (57.5%) are men and 48 (42.5%) are women. The mean age of patients is 46.3 ± 5.2 years. The structure of the instrumental algorithm for examining patients was presented: ultrasound of the abdominal cavity organs with clinical elastography – 98 (86.7%) patients, MRI of the liver with the mandatory inclusion of the DWI liver sequence in the protocol (n = 113). The b-factor values of 100/600/1000 were used for the liver DWI sequence. Liver biopsy was chosen as the reference method in 65 (57.5%) patients.Results. The patients were monitored for 12 months. At the first stage, the qualitative characteristics of the liver DWI sequence were assessed: no or there is a diffusion limitation. At the second stage, the quantitative indicators of the DWI sequence were assessed in the form of calculating the measured diffusion index and coefficient. In order to standardize the technique of liver DWI on MRI in patients with ALD, the results were compared with the data of clinical elastography (p < 0.01) and liver biopsy (p < 0.05). Upon admission and monitoring of patients (after 1, 3, 6, 9 months), a high correlation was found in the assessment of comparing the quantitative indicators of DWI with clinical elastography (r = 0.873) and an average correlation with biopsy data (r = 0.715).Conclusions. There was a high correlation between the limitation of liver diffusion on MRI and negative clinical and laboratory dynamics (r = 0.889) and in the absence of limitation of diffusion in the liver and positive clinical and laboratory dynamics (r = 0.885). DWI of the liver on MRI in patients with ALD has a high diagnostic and prognostic value in assessing abnormal abstinence regimen (AUROC = 0.903 (95% CI 0.871–0.911)). Diagnostic and prognostic significance of the developed criteria for DWI of the liver at MRI in patients with ABD at admission: for a qualitative assessment AUROC = 0.844 (95% CI 0.801–0.869), quantitative – AUROC = 0.908 (95% CI 0.875–0.911); with dynamic observation: for a qualitative assessment AUROC = 0.939 (95% CI 0.901–0.955), quantitative – AUROC = 0.919 (95% CI 0.871–0.931).