title: Assessment of chronic hepatitis and fibrosis: comparison of MR elastography and diffusion-weighted imaging.
abstract: OBJECTIVE
  The purpose of our study was to compare the utility of MR elastography (MRE) and diffusion-weighted imaging (DWI) in characterizing fibrosis and chronic hepatitis in patients with chronic liver diseases.
  
  
  METHODS
  Seventy-six patients with chronic liver disease underwent abdominal MRI, MRE, and DWI. Severities of liver fibrosis and chronic hepatitis were graded by histopathologic analysis according to standard disease-specific classifications. The overall predictive ability of MRE and DWI in assessment of fibrosis was compared by constructing a receiver operating characteristic (ROC) curve and calculating the area under the curve (AUC) on the basis of histopathologic analysis.
  
  
  RESULTS
  Using ROC analysis, MRE showed greater capability than DWI in discriminating stage 2 or greater (≥ F2), stage 3 or greater (≥ F3), and cirrhosis (≥ F4), shown as significant differences in AUC (p = 0.003, p = 0.001, and p = 0.001, respectively). Higher sensitivity and specificity were shown by MRE in predicting fibrosis scores ≥ F2 (91% and 97%), scores ≥ F3 (92% and 95%), and scores F4 (95% and 87%) compared with DWI (84% and 82%, 88% and 76%, and 85% and 68%, respectively). Although MRE had higher ability in identification of liver with fibrosis scores ≥ F1 than DWI, a significant difference was not seen (p = 0.398). Stiffness values on MRE increased in relation to increasing severity of fibrosis confirmed by histopathology scores; however, a consistent relationship between apparent diffusion coefficient (ADC) values and stage of fibrosis was not shown. In addition, liver tissue with chronic hepatitis preceding fibrosis may account for mild elevation of liver stiffness.
  
  
  CONCLUSIONS
  MRE had greater predictive ability in distinguishing the stages of liver fibrosis than DWI.
authors.affiliation: Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Ganger
authors.forename: Josh
authors.initials: J
authors.lastname: Levitsky
authors.forename: Laura A
authors.initials: LA
authors.lastname: Sternick
authors.forename: Robert J
authors.initials: RJ
authors.lastname: McCarthy
authors.forename: Zongming E
authors.initials: ZE
authors.lastname: Chen
authors.forename: Charles W
authors.initials: CW
authors.lastname: Fasanati
authors.forename: Bradley
authors.initials: B
authors.lastname: Bolster
authors.forename: Saurabh
authors.initials: S
authors.lastname: Shah
authors.forename: Sven
authors.initials: S
authors.lastname: Zuehlsdorff
authors.forename: Reed A
authors.initials: RA
authors.lastname: Omary
authors.forename: Richard L
authors.initials: RL
authors.lastname: Ehman
authors.forename: Frank H
authors.initials: FH
authors.lastname: Miller
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA; D006521:Hepatitis, Chronic / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA