MRI-based estimation of liver function by intravoxel incoherent motion diffusion-weighted imaging

Magn Reson Imaging. 2016 Oct;34(8):1220-5. doi: 10.1016/j.mri.2016.05.013. Epub 2016 Jun 1.

Abstract

Purpose: To explore the usefulness of intravoxel incoherent motion (IVIM) to evaluate the hepatic functional reserve as expressed by the model for Child-Pugh class.

Materials and methods: IVIM diffusion-weighted imaging (DWI) using 10 different b values were performed on a Philips 3.0T MR scanner in 70 patients with liver cirrhosis and 60 healthy volunteers as the control group. Patients with liver cirrhosis were subdivided into three groups: Child-Pugh class A: 29 cases; Child-Pugh class B: 19 cases; Child-Pugh class C: 22 cases. Pure molecular diffusion (D), pseudo-diffusion (D*), perfusion fraction (f) and apparent diffusion coefficient (ADC) values were calculated, and used to determine liver function, as indicated by the Child-Pugh class.

Results: The ICC values of D, D*, f and ADC between two radiologists were 0.997, 0.986, 0.985 and 0.995, respectively. D*, f and ADC values of liver cirrhosis group were significantly lower than control group (P<0.001, P=0.016, P=0.042, respectively). D*, f and ADC values significantly decreased with increasing Child-Pugh scores (p<0.05). Child-Pugh scores were inversely correlated with D* and f values (r=-0.423, r=-0.620, respectively). The areas under the curve (AUCs) of D* and f for evaluating liver function were 0.67-0.90 and 0.78-0.89, respectively.

Conclusion: IVIM DWI may be a useful image-based method for assessing liver function.

Keywords: Child–Pugh class; DWI; Intravoxel incoherent motion; Liver function.

MeSH terms

  • Adult
  • Diffusion Magnetic Resonance Imaging / methods*
  • Female
  • Humans
  • Liver / diagnostic imaging*
  • Liver / physiology*
  • Liver Cirrhosis / diagnostic imaging*
  • Liver Cirrhosis / physiopathology*
  • Male
  • Middle Aged
  • Motion
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Young Adult