Utility of diffusion weighted imaging (DWI) in assessment of liver fibrosis

Peer review under responsibility of Alexandria University Faculty of Medicine.

Available online 9 October 2017

Figures & data

Fig. 1 ADC map demonstrates measurements of ADC value of the liver and that of the spleen.

Table 1 Characteristic features of the studied groups.

	Group				p
	Patients		Control
Age	36.50 ± 9.32		35.80 ± 6.75		0.739
Sex	19	38.0%	13	52.0%	0.248
Female	31	62.0%	12	48.0%
Male
BMI	24.59 ± 2.58		23.55 ± 2.57		0.102

Table 2 Comparison between the two studied groups regarding the laboratory and DWI findings.

	Patient	Control	P
HB	13.95 ± 1.23	14.06 ± 0.91	0.694
RBCs	5.14 ± 0.84	4.76 ± 0.66	0.05^*
Platelet count (×103/cmm)	231.88 ± 87.47	316.60 ± 71.62	0.0001^*
WBCs	5.98 ± 1.90	5.41 ± 0.71	0.150
FBS	81.04 ± 7.34	81.36 ± 9.59	0.873
2 h PPS	107.12 ± 11.68	101.96 ± 8.48	0.05^*
Blood urea	24.18 ± 9.27	20.12 ± 6.56	0.05^*
Serum creatinine (mg/dl)	0.71 ± 0.20	0.78 ± 0.19	0.166
Serum cholesterol	133.32 ± 22.62	155.56 ± 31.25	0.001^*
Serum triglyceride	107.20 ± 19.80	125.56 ± 22.66	0.001^*
TSH	2.51 ± 0.65	2.12 ± 0.56	0.013^*
Free T3	3.44 ± 0.31	3.30 ± 0.27	0.045^*
Free T4	1.27 ± 0.28	1.19 ± 0.24	0.235
Serum AST	46.00 ± 25.30	20.32 ± 3.86	0.0001^*
Serum ALT	52.82 ± 27.06	20.80 ± 4.09	0.0001^*
Serum alkaline phosphatase	49.04 ± 16.41	41.56 ± 14.09	0.05^*
Serum GGT	18.84 ± 5.89	21.04 ± 3.23	0.087
Serum albumin (g/dl)	4.40 ± 0.48	4.65 ± 0.43	0.032^*
Serum bilirubin (mg/dl)	0.71 ± 0.15	0.64 ± 0.16	0.074
PA	92.29 ± 7.78	93.16 ± 4.81	0.609
AFP	4.22 ± 2.53	4.87 ± 1.53	0.242
Mean ADC (liver)	1.42 ± 0.19	1.70 ± 0.03	0.0001^*
ADC spleen	1.03 ± 0.20	1.32 ± 0.03	0.0001^*

Table 3 Results of liver biopsy of the studied patients.

Stage	Frequency	Percent
0	9	18.0
1	16	32.0
2	7	14.0
3	15	30.0
4	3	6.0

Table 4 Relation between mean ADC (liver) and ADC (spleen) and stage of liver fibrosis.

Stage		N	Mean	S.D	F	p
Mean ADC (liver)	0	9	1.661	0.125	16.8	0.001^*
	1	16	1.421	0.095
	2	7	1.286	0.087
	3	15	1.110	0.109
	4	3	1.07	0.165
ADC spleen	0	9	0.89201	0.05357	13.568	0.0001^*
	1	16	1.2817	0.15625
	2	7	1.0053	0.11868
	3	15	0.9533	0.01155
	4	3	0.8860	0.18823

Fig. 2 ROC curve and the cut off value of both mean ADC liver and normalized ADC in detecting the stage of liver fibrosis.

Table 5 The cut off value of both mean ADC liver and normalized ADC in detecting the stage of fibrosis.

Stage	Area under the curve (AUC)	Cut off value	Sensitivity	Specificity
Mean ADC (Liver)
Stage ≤ 3	0.89	>1.15	0.86	0.90
Stage > 3		<1.15	0.85	0.90
Mean normalized ADC
Stage ≤ 3	0.52	>0.52	0.610	0.607
Stage > 3		<0.52	0.60	0.55

Table 6 Correlation between different parameters of the studied patients.

		PA	AFP	Mean ADC (liver)
AFP	Pearson correlation	−0.122
	p	0.297
Mean ADC (liver)	Pearson correlation	−0.068	0.253^*
	p	0.559	0.029
ADC spleen	Pearson correlation	0.090	0.071	0.774^**
	p	0.440	0.542	0.0001^*