Abstract
BackgroundThere is obvious interest in finding a non-invasive diagnostic tool to detect the development of hepatic fibrosis and distinguish between its various stages. Chronic inflammation of the liver secondary to viral hepatitis, autoimmune conditions, sclerosing cholangitis, drug toxicity, chronic alcohol intake, different metabolic disorders, and steatosis lead to fibrosis and maybe cirrhosis. The current study aimed to assess the usefulness of diffusion-weighted magnetic resonance imaging (DW-MRI) in diagnosis of post hepatitis C fibrosis and detection of its stage.ResultsA prospective study had included 232 participants; 120 patients had chronic hepatitis C with/without HCC and 112 subjects had normal liver. There was no significant difference between the two groups regarding age or gender (p 0.192 and 0.227 respectively). DW-MRI was performed using 1.5 T machine. The mean liver ADC values and normalized liver ADC (liver ADC/spleen ADC) were measured at b value 800 s/mm2; both were significantly lower among cases than controls. Cutoff values of liver ADC were 1.531 × 10−3 mm2/s, 1.409 × 10−3 mm2/s, 1.192 × 10−3 mm2/s, and 1.093 × 10−3 mm2/s for METAVIR stages ≥ F1, ≥ F2, ≥ F3, and F4, respectively. Normalized liver ADC showed larger area under the curve (AUC) than mean liver ADC in all differentiation categories except for differentiating between F0 and all other fibrosis stages.ConclusionIn line with the literature, DW-MR imaging using b value of 800 s/mm2 has proved to be a valuable diagnostic technique for detection and staging of post hepatitis C fibrosis/cirrhosis being noninvasive procedure with acceptable accuracy. DWI using liver/spleen ADC values raised the diagnostic performance with AUC more than 90% in all fibrosis stages on METAVIR score.
Highlights
There is obvious interest in finding a non-invasive diagnostic tool to detect the development of hepatic fibrosis and distinguish between its various stages
Our present study aimed to evaluate Diffusion-weighted imaging (DWI) as a noninvasive technique to diagnose liver fibrosis and its stage compared to the liver biopsy and histopathological correlation
A total of 232 participants were included in this study; 120 patients had chronic hepatitis C with/without hepatocellular carcinoma (HCC), and 112 subjects had normal liver
Summary
There is obvious interest in finding a non-invasive diagnostic tool to detect the development of hepatic fibrosis and distinguish between its various stages. The current study aimed to assess the usefulness of diffusion-weighted magnetic resonance imaging (DW-MRI) in diagnosis of post hepatitis C fibrosis and detection of its stage. Liver biopsy is the gold standard for staging fibrosis and assessment of inflammatory necrotic changes [2, 3], yet it is an invasive tool and has underlying risk of bleeding. Development of noninvasive and accurate alternatives was necessary, e.g., transient elastography (fibroscan) and magnetic resonance (MR) elastography to diagnose liver fibrosis and its stage [5]. Use of diffusion-weighted MR imaging in assessment and staging of liver fibrosis has been encountered [6]
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