Diffusion-weighted magnetic resonance imaging for staging liver fibrosis is less reliable in the presence of fat and iron.
Objectives: To investigate the reliability of diffusion-weighted magnetic resonance imaging (DW-MRI) for staging liver fibrosis in the presence of fat and iron.Methods: Ninety-five patients, including 48 men and 47 women, aged 57.0 ± 14.2 years, underwent liver biopsy. Ninety-six samples were histol...
| Published in: | European Radiology Vol. 23; no. 5; pp. 1281 - 1288 |
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| Main Authors: | , , , , , |
| Format: | research Journal Article |
| Published: |
Springer Nature
May2013
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104269967&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104269967 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: May2013 vid: 23 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104269967 86879551 NLM23138385 2012081811 10.1007/s00330-012-2700-2 NLM23138385 104269967 ppf: 1281 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Diffusion-weighted magnetic resonance imaging for staging liver fibrosis is less reliable in the presence of fat and iron. aug: au: Bülow, Robin Mensel, Birger Meffert, Peter Hernando, Diego Evert, Matthias Kühn, Jens-Peter affil: Department of Radiology and Neuroradiology, Ernst Moritz Arndt University of Greifswald, Ferdinand-Sauerbruch-Straße NK, Greifswald, 17475, Germany, buelowr@uni-greifswald.de. sug: subj: Adipose Tissue Pathology Magnetic Resonance Imaging Methods Fatty Liver Metabolism Fatty Liver Pathology Iron Analysis Liver Cirrhosis Metabolism Liver Cirrhosis Pathology Female Human Male Middle Age Reproducibility of Results Sensitivity and Specificity Middle Aged: 45-64 years Female Male ab: Objectives: To investigate the reliability of diffusion-weighted magnetic resonance imaging (DW-MRI) for staging liver fibrosis in the presence of fat and iron.Methods: Ninety-five patients, including 48 men and 47 women, aged 57.0 ± 14.2 years, underwent liver biopsy. Ninety-six samples were histologically staged for liver fibrosis (0-Ishak score 0; 1-Ishak score 1-4; 2-Ishak score 5-6) and semiquantitatively graded for hepatic iron (0, no; 1, low; 2, moderate; 3, high iron) and for hepatic steatosis. Within 72 h after biopsy, navigator-triggered DW-MRI using b-values of 50/400/800 s/mm(2) was performed in a 1.5-T system, and apparent diffusion coefficients (ADC) were analysed. ADCs were correlated with fibrosis stage, steatosis grade, and iron grade using linear regression.Results: ADC did not correlate with fibrosis stages in either the overall group (n = 96; R (2) = 0.38; P = 0.17) or in the subgroup without liver iron and steatosis (n = 40; R (2) = 0.01; P = 0.75). ADC decreased significantly with steatosis grade in cases without iron and fibrosis (n = 42; R (2) = 0.28; ß = -5.3; P < 0.001). Liver iron was modestly correlated with ADC in patients without fibrosis and steatosis (n = 33; R (2) = 0.29; P = 0.04), whereas high iron concentrations were associated with low ADC values (group 3: β = -489; P = 0.005; reference:group 0) but intermediate levels were not (group 1/group 2: P = 0.93/P = 0.54; reference group: 0).Conclusions: ADC values are confounded by fat and iron. However, even in patients without fat or iron, DW-MRI does not adequately discriminate the stage of fibrosis.Key Points: • Diffusion-weighted magnetic resonance imaging (DW-MRI) is increasingly used to evaluate liver disease. • DWI using b-values of 50/400/800 s/mm (2) does not adequately quantify fibrosis. • Assessment of the apparent diffusion coefficient (ADC) is confounded by fat and iron. • Fat may influence ADCs by altering water diffusion. • Iron may influence ADCs by signal decay and noise floor effects. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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