Purpose: To assess the value of both DWI and late enhancement (LE) technique in the detection of moderate-severe liver fibrosis in chronic liver disease. Methods and Materials: A total of 25 patients (mean age 69) with known chronic liver disease (16 moderate and 9 severe fibrosis) without focal hepatic lesions and 15 patients without liver disease were enrolled. All of them underwent MRI (1.5 T GEHD) performed with an eight-channel phase-array coil. After standard examination, an axial BHDWI EPI sequence (b = 500) was acquired. We injected two doses (0.1 mmol/Kg ml) of intravascular-interstitial contrast media before and after dynamic evaluation. After 13 minutes, a BH IR-FastGR was acquired. Two different observers analysed both ADC values (obtained by positioning six ROIs on the right lobe) and LE patterns. Results: In 17 out of 25 patients, ADC was reduced (P < 0.0001; 0.82 ± 0.6SD x 10-3cm2/sec) with respect to controls (1.3 ± 0.46 SD x 10-3cm2/sec; specifity 84 %; sensitivity 68%). In eight patients with moderate fibrosis, ADC was normal. Healthy sample LE showed homogeneous intrahepatic enhancement. In 14 patients with moderate fibrosis, LE showed a reduction in signal intensity; in 8 with severe fibrosis, LE showed an irregular reticulation strongly suggestive of fibrotic septal tissue. Conclusion: Use of both DWI and LE techniques increase MRI accuracy in detecting liver fibrosis, but LE is more accurate in the evaluation of moderate fibrosis. This behaviour could be due to a reduction of macromolecular diffusion typically present in chronic liver disease. LE could be a new important tool for both detection and follow-up of moderate liver fibrosis.

To asses the diagnostic role of DWI sequence end contrast media late enhancement technique in the evaluation of liver fibrogenic evolutio in cronic liver disease

DI CESARE, Ernesto;MASCIOCCHI, CARLO
2009

Abstract

Purpose: To assess the value of both DWI and late enhancement (LE) technique in the detection of moderate-severe liver fibrosis in chronic liver disease. Methods and Materials: A total of 25 patients (mean age 69) with known chronic liver disease (16 moderate and 9 severe fibrosis) without focal hepatic lesions and 15 patients without liver disease were enrolled. All of them underwent MRI (1.5 T GEHD) performed with an eight-channel phase-array coil. After standard examination, an axial BHDWI EPI sequence (b = 500) was acquired. We injected two doses (0.1 mmol/Kg ml) of intravascular-interstitial contrast media before and after dynamic evaluation. After 13 minutes, a BH IR-FastGR was acquired. Two different observers analysed both ADC values (obtained by positioning six ROIs on the right lobe) and LE patterns. Results: In 17 out of 25 patients, ADC was reduced (P < 0.0001; 0.82 ± 0.6SD x 10-3cm2/sec) with respect to controls (1.3 ± 0.46 SD x 10-3cm2/sec; specifity 84 %; sensitivity 68%). In eight patients with moderate fibrosis, ADC was normal. Healthy sample LE showed homogeneous intrahepatic enhancement. In 14 patients with moderate fibrosis, LE showed a reduction in signal intensity; in 8 with severe fibrosis, LE showed an irregular reticulation strongly suggestive of fibrotic septal tissue. Conclusion: Use of both DWI and LE techniques increase MRI accuracy in detecting liver fibrosis, but LE is more accurate in the evaluation of moderate fibrosis. This behaviour could be due to a reduction of macromolecular diffusion typically present in chronic liver disease. LE could be a new important tool for both detection and follow-up of moderate liver fibrosis.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11697/22309
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