title: Initial study of biexponential model of intravoxel incoherent motion magnetic resonance imaging in evaluation of the liver fibrosis.
abstract: BACKGROUND
  The diagnosis of liver fibrosis is a difficult task at any time using conventional clinical imaging. Intravoxel incoherent motion (IVIM) can be used to investigate both diffusion and perfusion changes in tissues. This study was designed to determine the value of IVIM in the diagnosis and staging of liver fibrosis.
  
  
  METHODS
  IVIM examinations were performed on a GE 3.0T MR scanner in 25 patients with liver fibrosis and 25 healthy volunteers as the control group. Patients with liver fibrosis diagnosis were confirmed by pathology and staged on a scale of F0-4. The standard ADC values and the values of a biexponential model (slow ADC (Dslow), fast ADC (Dfast) and fraction of fast ADC (FF)) were measured in three liver regions per person. The mean standard ADC values, Dslow values, Dfast values and FF values from the study group were compared among the right posterior hepatic lobe, right anterior hepatic lobe and medial segment of the left lobe. Receiver Operating Characteristic (ROC) curves and independent-samples t-tests were used to calculate the mean standard ADC values, Dslow values, Dfast values and FF values from the study group and the control group. Spearman rho correlation analysis was used for the stage of liver fibrosis. The liver fibrosis stages between the groups F0-1 and F2-4, the groups F0-2 and F3-4 were compared.
  
  
  RESULTS
  Among the liver fibrosis, there was no significant difference in the mean standard ADC values, Dslow values, Dfast values, and FF values obtained from the right posterior hepatic lobe, right anterior hepatic lobe and medial segment of the left lobe. Using ROC analysis, the Area Under the Curve (AUC) values of standard ADC, Dslow, Dfast, FF were all between 0.7 to 0.9. The mean standard ADC values, Dslow values, Dfast values and FF values of the liver in the study group were significantly lower than the values in the control group (P < 0.05). As the stage of the fibrosis increased, the values decreased by Spearman rho correlation analysis. The mean values (standard ADC, Dslow, Dfast, and FF) of liver fibrosis stages between the groups F0-1 and F2-4, the groups F0-2 and F3-4 showed significant differences (P < 0.05).
  
  
  CONCLUSIONS
  IVIM can reflect the conditions of perfusion and diffusion in liver fibrosis and thus distinguish between normal liver and liver fibrosis. The IVIM technique may serve as a valuable tool for detecting and characterizing liver fibrosis, and monitoring its progression in a noninvasive manner.
authors.affiliation: Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong 250100, China; Department of Radiology, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China.
authors.forename: Cuiyun
authors.initials: C
authors.lastname: Chen
authors.affiliation: Medical Imaging Research Institute, Binzhou Medical University, Yantai, Shandong 264003, China. Email: binwang001@aliyun.com.
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Radiology, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China. Email: shyshidapeng@163.com.
authors.forename: Dapeng
authors.initials: D
authors.lastname: Shi
authors.affiliation: Department of Radiology, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China.
authors.forename: Fangfang
authors.initials: F
authors.lastname: Fu
authors.affiliation: Department of Radiology, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China.
authors.forename: Jiliang
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Radiology, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China.
authors.forename: Zejun
authors.initials: Z
authors.lastname: Wen
authors.affiliation: Department of Radiology, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China.
authors.forename: Shaocheng
authors.initials: S
authors.lastname: Zhu
authors.affiliation: Department of Radiology, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China.
authors.forename: Junling
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Radiology, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Lin
authors.affiliation: Department of Radiology, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Radiology, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China.
authors.forename: Shewei
authors.initials: S
authors.lastname: Dou
mesh_terms: D000328:Adult; D000368:Aged; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged