| Sumario: | Objective: To investigate the usefulness of intravoxel incoherent motion (IVIM) in determining the severity of hepatic fibrosis, steatosis, and inflammation in patients with chronic liver disease.Methods: Forty-nine patients who had liver MRI with IVIM sequence and liver biopsy within three months of MRI were enrolled. A reviewer, blinded to histology, placed regions of interest of 1-2 cm2 in the right liver lobe. In addition, the first twenty patients were assessed with a second reviewer. Perfusion fraction (f), pseudodiffusion coefficient (<italic>D</italic>fast), true diffusion coefficient (<italic>D</italic>slow), and apparent diffusion coefficient (ADC) were calculated from normalized signal intensities that were fitted into a biexponential model. Errors in the model were minimized with global stochastic optimization using Simulated Annealing. ANOVA with post hoc Tukey-Kramer test and multivariate generalized linear model analysis were performed, using histological findings as the gold standard.Results: The most common etiologies for liver disease were hepatitis C and alcohol, accounting together for 76% (37/49) of patients. Low-grade fibrosis (F0, F1), hepatic steatosis, and inflammation were seen in 24% (12/49), 31% (15/49), and 29% (14/49) of patients, respectively. The interobserver correlation was poor for <italic>D</italic>fast and <italic>D</italic>slow (0.105, 0.173) and moderate for f and ADC (0.461, 0.418). ANOVA showed a strong inverse association between <italic>D</italic>fast and liver fibrosis grade (<italic>p</italic> = 0.001). A weak inverse association was seen between ADC and hepatic steatosis (<italic>p</italic> = 0.059). Multivariate general linear model revealed that the only significant association between IVIM parameters and pathological features was between <italic>D</italic>fast and fibrosis. On ROC curve analysis, <italic>D</italic>fast < 23.4 × 10−3 mm2/s had a sensitivity of 82.8% and a specificity of 64.3% in predicting high-grade fibrosis.Conclusion: <italic>D</italic>fast has the strongest association with hepatic fibrosis but has weak interobserver correlation. IVIM parameters were not significantly associated with hepatic inflammation or steatosis.
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