Jeong Hee Yoon MD, Presenter: Nothing to Disclose

Jeong Min Lee MD, Abstract Co-Author: Research Grant, Guerbet SA Equipment support, Siemens AG Research Grant, Bayer AG

Joon Koo Han MD, Abstract Co-Author: Nothing to Disclose

Byung Ihn Choi MD, PhD, Abstract Co-Author: Research Consultant, Samsung Electronics Co Ltd

To explore changes of liver parenchyma by using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with dual-input, dual-compartment model and diffusion-weighted imaging with intravoxel incoherent motion (DWI-IVIM) in histologically diagnosed hepatic fibrosis (HF).

This prospective study was approved by our institutional review board and informed consent was obtained from all patients. A total of 34 patients (M:F=17:17, mean age 45.6 years) who were diagnosed with HF were enrolled (F0 [n=15]; F1 [n=2]; F2 [n=9]; F3 [n=4]; and F4 [n=4]). All patients underwent DCE-MRI and DWI using ten b-values (0~1000sec/mm2) at 1.5T scanner before histological examination. Parameters of DCE-MRI (arterial flow, portal flow [ml/min/100g], MTT (sec), Kep [1/min/100]) and those of DWI (ADCtotal, Dt, D* [x10-3mm2/sec] and f [%]) were compared between no or early HF (F0-1) and significant HF (≥F2). The diagnostic performances for assessing advanced HF were evaluated for each parameter using multiple logistic regression and receiver operating characteristic analyses.

Compared to F0-1, advanced HF showed significantly lower ADCtotal (1.32±0.19 vs. 1.14±0.13, respectively, P<0.005), Dt (1.10±0.18, 0.98±0.14, respectively) and D* (82.2±20.1 vs. 44.3±23.2, respectively, P<0.001). However, f were not significantly different between two groups (P>0.05). Advanced HF showed lower portal flow (P<0.05) and prolonged MTT, compared to F0-1 (P<0.005), whereas arterial flow was significantly higher in advanced HF than F0-1 (P<0.05). Kep was significantly lower in advanced HF than F0-1 (419.6±66.7 vs. 552.0±226.8, P<0.05). To detect advanced HF, D* (AUC 0.88, Az value of ≤54.74 [x10-3mm2/sec]) and Kep (AUC 0.82, Az value of ≤503.97[1/min/100]) were the most significant parameters (P<0.001).  

DCE-MRI using dual-input model and IVIM-DWI non-invasively detected perfusion and diffusion changes of advanced HF and identified portal and arterial flow contribution to the liver. 

HF causes diffusion and perfusion changes in the liver. Pathophysiologic changes of HF could be non-invasively monitored by using multiparamteric MRI. 

Yoon, J, Lee, J, Han, J, Choi, B, Multiparametric Magnetic Resonance Imaging for Assessing Pathophysiologic Changes in Hepatic Fibrosis.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14018896.html