Modern possibilities of quantitative assessment of diffusion-weighted images in magnetic resonance imaging of liver in diagnosis of alcoholic liver disease

Abstract

Objective. To evaluate the modern possibilities of quantitative assessment of diffusion-weighted imaging (DWI) using magnetic resonance imaging of the liver (MRI) in alcoholic liver disease (ALD). Material and methods. 121 patients with ALD were examined. The structure of clinical forms: 27 (22.3 %) – steatosis, 29 (23.9 %) – steatohepatitis, 48 (39.7 %) – hepatitis, 17 (14.1 %) – cirrhosis. The patients were hospitalized in the gastroenterology department of the Clinical Hospital No. 1 in Smolensk (September 2019 – March 2020), followed by outpatient observation (April 2020 – January 2022). All patients underwent a comprehensive radiological examination, including ultrasound examination (ultrasound) of the abdominal organs with clinical elastography (CE) of the liver (n = 121) (transient elastography/compression elastography/shear wave elastography), MRI with DWI of the liver was mandatory in the design of the study (n = 121). Results. According to the CE data, there is no possibility to confirm the clinical form of ALD in a patient, the stage of the fibrous process in the liver parenchyma is limited by marginal results; a liver biopsy allows you to fully establish the stage of fibrosis and suspect the clinical form of ALD. According to the quantitative assessment of DWI of the liver during MRI in patients with ALD, criteria for clinical forms were established in comparison with CE: for steatosis – 2.66 ± 0.90 × 10 –3 mm 2 /sec corresponds to F0–F1, for steatohepatitis – 2.14 ± 0,50 × 10 –3 mm 2 /sec – F1–F2, for hepatitis – 1.75 ± 0.60 × 10 –3 mm 2 /sec – F2–F3, for cirrhosis – 1.15 ± 0.60 × 10 –3 mm 2 /sec – F4 (AUROC = 0.985; 95 % CI: 0.945–0.912). Conclusion. Upon admission and monitoring of patients (after 1, 3, 6, 9, 12 months), there is a high correlation in assessing the comparison of quantitative indicators of DWI with CE (r = 0.873) and an average correlation with liver biopsy data (r = 0.715). The diagnostic and prognostic significance of the developed criteria for DWI of the liver during MRI in patients with ALD at admission was assessed for quantitative assessment of AUROC = 0.908 (95 % CI: 0.875–0.911).