Liver lobe based intravoxel incoherent motion diffusion weighted imaging in hepatitis B related cirrhosis: Association with child-pugh class and esophageal and gastric fundic varices

Medicine, vol. 99, pp. e18671

Abstract

Liver cirrhosis is a common chronic progressive liver disease in clinical practice, and intravoxel incoherent motion (IVIM) is a promising magnetic resonance method to assess liver cirrhosis, so our purpose was to investigate association of liver-lobe-based IVIM-derived parameters with hepatitis-B-related cirrhosis and its severity, and esophageal and gastric fundic varices. Seventy-four patients with hepatitis-B-related cirrhotic and 25 healthy volunteers were enrolled and underwent upper abdominal IVIM diffusion-weighted imaging with b-values of 0, 20, 50, 80, 100, 200, 400, 600, and 800 s/mm. IVIM-derived parameters (D, pure molecular diffusion; D, pseudo diffusion; and f, perfusion fraction) of left lateral lobe (LLL), left medial lobe (LML), right lobe (RL), and caudate lobe (CL) were assessed statistically to show their associations with cirrhosis and its severity, and esophageal and gastric fundic varices. In this research, we found that D, D, and f values of LLL, LML, RL, and CL were lower in cirrhotic liver than in normal liver (all P-values <.05). D, D, and f values of LLL, LML, RL, and CL were inversely correlated with Child-Pugh class of cirrhosis (r = -0.236 to -0.606, all P-values <.05). D of each liver lobe, D of LLL and CL, and f of LLL, LML, and CL in patients with esophageal and gastric fundic varices were lower than without the varices (all P-values <.05). D values of RL and CL could best identify cirrhosis, and identify esophageal and gastric fundic varices with areas under receiver-operating characteristic curve of 0.857 and 0.746, respectively. We concluded that liver-lobe-based IVIM-derived parameters can be associated with cirrhosis, and esophageal and gastric fundic varices.

Authors 10

1. Fan Chen

   North Sichuan Medical University · Army Medical University · Affiliated Hospital of North Sichuan Medical College · Southwest Hospital

   Affiliation as printed

   Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing

   Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan

   99:2(e18671)

2. Yanli Chen

   North Sichuan Medical University · Army Medical University · Affiliated Hospital of North Sichuan Medical College · Southwest Hospital

   Affiliation as printed

   Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing

   Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan

   99:2(e18671)

3. Tian‐wu Chen corresponding Aachen = pseudo-diffusion coefficient

   North Sichuan Medical University · DWI – Leibniz Institute for Interactive Materials · Affiliated Hospital of North Sichuan Medical College

   Affiliation as printed

   Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan

   = pseudo-diffusion coefficient, DWI = diffusion weighted imaging

4. Rui Li corresponding Aachen = pseudo-diffusion coefficient

   North Sichuan Medical University · DWI – Leibniz Institute for Interactive Materials · Affiliated Hospital of North Sichuan Medical College

   Affiliation as printed

   Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan

   = pseudo-diffusion coefficient, DWI = diffusion weighted imaging

5. Yu Pu

   North Sichuan Medical University · Affiliated Hospital of North Sichuan Medical College

   Affiliation as printed

   Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan

   99:2(e18671)

6. Xiao Ming Zhang

   North Sichuan Medical University · Affiliated Hospital of North Sichuan Medical College

   Affiliation as printed

   Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan

   99:2(e18671)

7. Hongjun Li

   Capital Medical University · Beijing YouAn Hospital

   Affiliation as printed

   Department of Radiology, Beijing YouAn Hospital, Capital Medical University, Beijing, China

   99:2(e18671)

8. Sun Tang

   North Sichuan Medical University · Affiliated Hospital of North Sichuan Medical College

   Affiliation as printed

   Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan

   99:2(e18671)

9. Jinming Cao

   North Sichuan Medical University · Affiliated Hospital of North Sichuan Medical College

   Affiliation as printed

   Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan

   99:2(e18671)

10. Jianqiong Yang

    North Sichuan Medical University · Affiliated Hospital of North Sichuan Medical College

    Affiliation as printed

    Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan

    99:2(e18671)