Hepatic ADC value correlates with cirrhotic severity of patients with biliary atresia.
BACKGROUND
At least 40% of survivors of biliary atresia have progressive cirrhosis even after undergoing Kasai operation. The values of hepatic apparent diffusion coefficient and apparent-diffusion-coefficient-related indices were applied to biliary atresia patients and correlated with cirrhotic severity scores of model for end-stage liver disease or pediatric end-stage liver disease model, Child-Turcotte, and Child-Pugh systems.


METHODS
Thirty-three biliary atresia patents (mean=1140, 61-4314 days of age) received magnetic resonance image examinations due to complications of biliary atresia from April 2008 to August 2009. Two non-breath-hold diffusion weighted imaging sequences were performed with motion-probing gradients in three directions with two b values: 0/100 and 0/500 s/mm2; 1000 ms/61.1 ms, time to repeat/time to echo; number of excitation, 1.0; 8 mm section thickness; 40 cm×40 cm field of view; 128×256 matrix in all biliary atresia patients and 18 control subjects. We used the Spearman rank correlation test to analyze the relationship among the scores of model for end-stage liver disease or pediatric end-stage liver disease model, Child-Turcotte and Child-Pugh scores and right hepatic apparent diffusion coefficients, apparent diffusion coefficient using b factor of 500-albumin product and alanine transaminase/apparent diffusion coefficient with b factor of 500 ratio.


RESULTS
The right hepatic apparent diffusion coefficient using b factor of 100, apparent diffusion coefficient with b factor of 500 and product of apparent diffusion coefficient with b factor of 500-albumin level were significantly negatively correlated (p≤0.0125) with model for end-stage liver disease or pediatric end-stage liver disease model, Child-Turcotte, and Child-Pugh scores of biliary atresia patients. The ratio of alanine transaminase level/right hepatic apparent diffusion coefficient with b factor of 500 was also significantly (p≤0.0251), moderately correlated with Child-Turcotte and Child-Pugh scores (rho=0.5256 and 0.7518, respectively).


CONCLUSIONS
Right hepatic apparent diffusion coefficient with b factor of 500 and alanine transaminase/right hepatic apparent diffusion coefficient with b factor of 500 can be useful for long-term follow-up of cirrhotic severity in biliary atresia patients.
Institute of Biomedical Engineering, College of Engineering, National Taiwan University, and Department of Radiology, Cathay General Hospital, Taipei, Taiwan. jamesmyh@yahoo.com.tw
Yuan Heng
YH
Mo
Fu Shan
FS
Jaw
Ming Chih
MC
Ho
Yung Cheng
YC
Wang
Steven Shinn Forng
SS
Peng
D000465:Algorithms; D001656:Biliary Atresia / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013223:Statistics as Topic