Published in:
01-08-2020 | Hepatitis B | Hepatobiliary
Intravoxel incoherent motion parameters in the evaluation of chronic hepatitis B virus-induced hepatic injury: fibrosis and capillarity changes
Published in: Abdominal Radiology | Issue 8/2020
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Objective
To evaluate the diagnostic efficacy of intravoxel incoherent motion (IVIM) parameters in hepatitis B virus (HBV)-induced hepatic fibrosis using different calculation methods and to investigate histopathologic origins.
Materials and methods
Liver biopsies from 37 prospectively recruited chronic hepatitis B patients were obtained. Twelve b-value (0–1000 s/mm2) diffusion-weighted imaging (DWI) was performed with a 1.5 T scanner and was followed by blinded percutaneous liver biopsy. All biopsy specimens were evaluated with Ishak staging, and the microvascular density (MVD) was calculated. Patients were classified as having no/mild (F0–1), moderate (F2–3), or marked (F4–5) fibrosis. Pseudodiffusion (D*), the perfusion fraction (f), and the apparent diffusion coefficient (ADC) were calculated using all b-values, while true diffusion (D) was calculated using all b-values [D0–1000] and b-values greater than 200 s/mm2 [D200–1000]. Three concentric regions of interest (ROIs) (5, 10, and 20 mm) centered on the biopsy site were used.
Results
D* was correlated with the MVD (p = 0.015, Pearson’s r = 0.415), but f was not (p = 0.119). D0–1000 was inversely correlated with Ishak stage (p = 0.000, Spearman’s rs = − 0.685) and was significantly decreased in all the fibrosis groups; however, only the no/mild and marked fibrosis groups had significantly different D200–1000 values. A pairwise comparison of receiver operating characteristic (ROC) curves of D0–1000 and D200-1000 showed significant differences (p = 0.039). D* was the best at discriminating early fibrosis (AUC = 0.861), while the ADC best discriminated advanced fibrosis (AUC = 0.964).
Conclusion
D* was correlated with the MVD and is a powerful parameter to discriminate early hepatic fibrosis. D significantly decreased with advanced fibrosis stage when using b-values less than 200 s/mm2 in calculations.