Abstract

Early diagnosis of liver fibrosis is important. The objective of this study was to explore the characteristics and to assess the accuracy of monoexponential, stretched exponential models (SEM), and diffusion kurtosis imaging (DKI) with diffusion-weighted imaging (DWI)-magnetic resonance imaging (MRI) in various stages of liver fibrosis in two standard rat models induced by carbon tetrachloride (CCl4) and biliary duct ligation (BDL). Parameters (ADC, Dapp, Kapp, DDC, α) were measured with a 3.0T MRI. Liver fibrosis stages (F0–F4) were defined by METAVIR scoring. Parameters (ADC, Dapp, DDC) were found to be negatively associated (r: -0.675~-0.789; P<0.05) with advancement of fibrosis stage. The analysis of receiver operating characteristic (ROC) curves illustrated that the areas under the curves (AUC) for ADC, Dapp, and DDC were 0.687~0.957, 0.805~0.938 and 0.876~1.000, respectively. The study showed that (ADC, Dapp, Kapp, DDC, α) from various diffusion models reflected pathological and physiological tissue changes. We conclude that SEM and DKI may provide more accurate information about diffusion, and non-Gaussian diffusion analysis may be a complementary tool for the assessment of liver fibrosis.

Highlights

  • Liver fibrosis is a reparative response of liver tissues to the chronic liver injuries of various causes

  • The objective of this study was to explore the characteristics and to assess the accuracy of monoexponential, stretched exponential models (SEM), and diffusion kurtosis imaging (DKI) with diffusionweighted imaging (DWI)-magnetic resonance imaging (MRI) in various stages of liver fibrosis in two standard rat models induced by carbon tetrachloride (CCl4) and biliary duct ligation (BDL)

  • We employed the stretched exponential model and diffusion kurtosis imaging to characterize the non-Gaussian behavior of the diffusion-related signal decay in two animal models of liver fibrosis

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Summary

Introduction

Liver fibrosis is a reparative response of liver tissues to the chronic liver injuries of various causes. When the rate of synthesis of extracellular matrix (ECM) exceeds that of degradation, distortion of liver lobules and blood circulation disorders due to cirrhosis can occur. Fibrosis is reversible, [1, 2] and its progression into cirrhosis and cancer can be stopped or delayed by early treatment. Early diagnosis of liver fibrosis is clinically important. There are three types of diagnostic methods for liver fibrosis currently being used clinically: percutaneous biopsy, serological tests, and imaging. The standard method for diagnosis of liver fibrosis is biopsy; this is invasive and not suitable for repeated examinations or dynamic observations [3]. The application of serological testing is largely limited by low sensitivity and specificity [4, 5]

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