title: Apparent diffusion coefficient measurements with diffusion-weighted magnetic resonance imaging for evaluation of hepatic fibrosis.
abstract: OBJECTIVE
  To evaluate the use of apparent diffusion coefficient (ADC) measurements based on diffusion-weighted MRI (DWI) to assess stage of liver disease.
  
  
  METHODS
  A total of 31 patients who underwent both a liver biopsy and DWI and 132 patients who only underwent DWI were enrolled. Biopsy specimens were scored for fibrosis and necroinflammation according to the Knodell histology activity index (HAI). The 31 patients consisted of 21 patients with chronic hepatitis and 10 with cirrhosis (Child-Pugh stage A in nine and stage B in one), and the 132 patients consisted of 56 patients with cirrhosis (Child-Pugh stage A in 41, stage B in 10, and stage C in five), 42 with chronic hepatitis, and 34 with normal liver function. The ADCs in the liver parenchyma were measured using DWI with relatively low b factors (b = 0.01 and 128.01 seconds/mm(2)) and were compared among the HAI scores and among patients with cirrhosis, chronic hepatitis, and normal liver function.
  
  
  RESULTS
  The ADCs decreased as the fibrosis score in the HAI increased, and the correlation was statistically significant (P < 0.0001). No relationship between the ADCs and the necroinflammation scores in the HAI was found. The ADCs decreased as the stage of liver disease progressed or as the Child-Pugh stage progressed, and these relationships were statistically significant (P < 0.0001).
  
  
  CONCLUSIONS
  ADC measurements are potentially useful for the evaluation of fibrosis staging in the liver.
authors.affiliation: Department of Radiology, School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Miwa
authors.initials: M
authors.lastname: Koinuma
authors.forename: Isamu
authors.initials: I
authors.lastname: Ohashi
authors.forename: Kaoru
authors.initials: K
authors.lastname: Hanafusa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Shibuya
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D019694:Hepatitis B, Chronic / Q000175:diagnosis; D019698:Hepatitis C, Chronic / Q000175:diagnosis; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies