Value of diffusion imaging of magnetic resonancefunction in pathological grading and liver fibrosis in patients with liver cirrhosis

  Objective  To explore the value of magnetic resonance functional diffusion imaging (DWI) in the evaluation of liver fibrosis and pathological grading of cirrhosis in patients with primary cholestasis cirrhosis (PBC).

  Methods  Routine magnetic resonance imaging and DWI were performed in 129 patients with primary cholestasis and 23 healthy volunteers. Hepatic fibrosis stagings was classified according to the pathological diagnosis of liver puncture, and hepatic fibrosis in S4 patients were classified according to Child-Pugh classification criteria. Single factor repeated measures analysis was used to compare the changes in Apparent dispersion coefficient (ADC) values during liver fibrosis progression and cirrhosis grade at b values of 100~1 000 s/mm². Spearman correlation analysis was used to investigate the correlation between liver fibrosis progression, cirrhosis grading and ADC values. The receiver operating curve (AUC) was used to assess the diagnostic efficacy of ADC values in S2 to S3 liver fibrosis and S4 cirrhosis.

  Results  When the b value was 600 s/mm², 800 s/mm², 1000 s/mm², the ADC values of patients with liver fibrosis in S3 and S4 groups were significantly lower than those in normal group, S0, S1 and S2 groups (P < 0.05). The ADC values were significantly lower with the worse of cirrhosis grading, and the difference was statistically significant (P < 0.05). When the b value was 600, 800, 1 000 s/mm², the ADC value was negatively correlated with the liver fibrosis process(P < 0.01). When the b value was from100 s/mm² to 1000 s/mm², there was a negative correlation betweenADC value and cirrhosis grade (P < 0.01). When the b value was 600 s/mm², ADC≤1.65×10^-3 mm²/s and ADC≤1.23×10^-3 mm²/s were the diagnostic criteria for significant fibrosis and cirrhosis, sensitivity were 85.8%and 91.5%, respectively, and specificity were 75.9 % and 84.4%, respectively.

  Conclusion  DWI is of high clinical value in the diagnosis of liver fibrosis and grading diagnosis of cirrhosis in patients with primary cholestasis. The diagnostic performance is highest when the b value is 600 s/mm².