Literature DB >> 33074424

Noninvasive DW-MRI metrics for staging hepatic fibrosis and grading inflammatory activity in patients with chronic hepatitis B.

Fangfang Fu1, Xiaodong Li1, Qiuyu Liu2, Cuiyun Chen1, Yan Bai1, Dapeng Shi1, Jia Sang3, Kaiyu Wang4, Meiyun Wang5.   

Abstract

PURPOSE: To assess the value of various diffusion parameters obtained from monoexponential, biexponential, and stretched-exponential diffusion-weighted imaging (DWI) models for staging hepatic fibrosis (HF) and grading inflammatory activity in patients with chronic hepatitis B (CHB).
METHODS: 82 patients with CHB and 30 healthy volunteers underwent DWI with 13 b-values on a 3T MRI unit. The standard apparent diffusion coefficient (ADCst) was calculated using a monoexponential model. The true diffusion coefficient (Dt), pseudo-diffusion coefficient (Dp), and perfusion fraction (f) were calculated using a biexponential model. The distributed diffusion coefficient (DDC) and water-molecule diffusion heterogeneity index (α) were calculated using a stretched-exponential model. Receiver operating characteristic (ROC) curves were performed for diffusion parameters to compare the diagnosis performance.
RESULTS: The distributions of hepatic fibrosis stages and the inflammatory activity grades (METAVIR scoring system) were as follows: F0, n = 1; F1, n = 16; F2, n = 31; F3, n = 19; and F4, n = 15. A0, n = 1; A1, n = 14; A2, n = 46; and A3, n = 21. ADCst, Dt and DDC values showed negative correlation with the fibrosis stage (r = - 0.418, - 0.717 and - 0.630, all P < 0.001) and the inflammatory activity grade (r = - 0.514, - 0.626 and - 0.550, all P < 0.001). The area under the ROC curve (AUC) of Dt (AUC = 0.854, 0.881) and DDC (AUC = 0.794, 0.834) were significantly higher than that of ADCst (AUC = 0.637, 0.717) in discriminating significant fibrosis (≥ F2) and advanced fibrosis (≥ F3) (all P < 0.05). Although Dt (AUC = 0.867, 0.836) and DDC (AUC = 0.810, 0.808) showed higher AUCs than ADCst (AUC = 0.767, 0.803), there was no significant difference in their ability in detecting inflammatory activity grade ≥ A2/A3 (P > 0.05).
CONCLUSIONS: Dt and DDC are promising indicators and outperform ADCst for staging HF. While both Dt and DDC have similar diagnostic performance compared with ADCst for grading inflammatory activity.

Entities:  

Keywords:  Chronic; Diffusion magnetic resonance imaging; Fibrosis; Hepatitis B; Liver; Liver cirrhosis

Year:  2020        PMID: 33074424     DOI: 10.1007/s00261-020-02801-2

Source DB:  PubMed          Journal:  Abdom Radiol (NY)


  24 in total

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Authors:  Scott L Friedman
Journal:  J Hepatol       Date:  2003       Impact factor: 25.083

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Review 4.  Diffusion-weighted MR imaging of the liver.

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Journal:  Radiology       Date:  2010-01       Impact factor: 11.105

5.  Evaluation of the mean and entropy of apparent diffusion coefficient values in chronic hepatitis C: correlation with pathologic fibrosis stage and inflammatory activity grade.

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Journal:  Radiology       Date:  2011-01-19       Impact factor: 11.105

6.  MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders.

Authors:  D Le Bihan; E Breton; D Lallemand; P Grenier; E Cabanis; M Laval-Jeantet
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Review 7.  Defective T-cell immunity in hepatitis B virus infection: why therapeutic vaccination needs a helping hand.

Authors:  Mala K Maini; Laura J Pallett
Journal:  Lancet Gastroenterol Hepatol       Date:  2018-03

8.  Value of diffusion-weighted MRI for assessing liver fibrosis and cirrhosis.

Authors:  Kumaresan Sandrasegaran; Fatih M Akisik; Chen Lin; Bilal Tahir; Janaki Rajan; Romil Saxena; Alex M Aisen
Journal:  AJR Am J Roentgenol       Date:  2009-12       Impact factor: 3.959

Review 9.  Diagnosis and quantitation of fibrosis.

Authors:  Diarmuid S Manning; Nezam H Afdhal
Journal:  Gastroenterology       Date:  2008-05       Impact factor: 22.682

Review 10.  Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013.

Authors:  Aparna Schweitzer; Johannes Horn; Rafael T Mikolajczyk; Gérard Krause; Jördis J Ott
Journal:  Lancet       Date:  2015-07-28       Impact factor: 79.321

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