title: Intravoxel Incoherent Motion Diffusion Weighted MR Imaging at 3.0 T: Assessment of Steatohepatitis and Fibrosis Compared with Liver Biopsy in Type 2 Diabetic Patients.
abstract: OBJECTIVE
  To evaluate the capability of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) to assess steatohepatitis and fibrosis determined by histopathology in type 2 diabetic patients.
  
  
  METHODS
  Fifty-nine type 2 diabetic patients (49 women, 10 men; mean age, 54 ± 9 years) were submitted to liver biopsy for the evaluation of non-alcoholic fatty liver disease (NAFLD) and underwent DWI on a 3.0T MR system using 10 b values. Institutional approval and patient consent were obtained. Pure molecular-based (D), perfusion-related (D*), and vascular fraction (f) were calculated using a double exponential model and least squares curve fitting. D, D*, and f were compared between patients with and without steatohepatitis and between patients with and without fibrosis. The variables were compared by using the Ranksum test and Student t-test.
  
  
  RESULTS
  Steatohepatitis was observed in 22 patients and fibrosis in 16 patients. A lower D median (0.70 s/mm2 vs. 0.83 s/mm2, p<0.05) and a lower D* median (34.39 s/mm2 vs. 45.23 s/mm2, p<0.05) were observed among those with steatohepatitis. A lower D median (0.70 s/mm2 vs. 0.82 s/mm2, p<0.05) and a lower D* median (35.01 s/mm2 vs. 44.76 s/mm2, p=0.05) were also observed among those with fibrosis.
  
  
  CONCLUSIONS
  IVIM-DWI has the potential to aid in the characterization of steatohepatitis and fibrosis.
authors.affiliation: D'Or Institute for Research and Education, Rio de Janeiro, Brazil; Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Daniella Braz
authors.initials: DB
authors.lastname: Parente
authors.affiliation: D'Or Institute for Research and Education, Rio de Janeiro, Brazil; Institute of Physics of São Carlos, University of São Paulo, São Carlos, Brazil.
authors.forename: Fernando Fernandes
authors.initials: FF
authors.lastname: Paiva
authors.affiliation: D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
authors.forename: Jaime Araújo
authors.initials: JA
authors.lastname: Oliveira Neto
authors.affiliation: University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Lilian
authors.initials: L
authors.lastname: Machado-Silva
authors.affiliation: Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Fatima Aparecida Ferreira
authors.initials: FA
authors.lastname: Figueiredo
authors.affiliation: Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Valeria
authors.initials: V
authors.lastname: Lanzoni
authors.affiliation: University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Carlos Frederico Ferreira
authors.initials: CF
authors.lastname: Campos
authors.affiliation: D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
authors.forename: Pedro Emmanuel Alvarenga Americano
authors.initials: PE
authors.lastname: do Brasil
authors.affiliation: University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Marilia de Brito
authors.initials: Mde B
authors.lastname: Gomes
authors.affiliation: D'Or Institute for Research and Education, Rio de Janeiro, Brazil; Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Renata de Mello
authors.initials: Rde M
authors.lastname: Perez
authors.affiliation: D'Or Institute for Research and Education, Rio de Janeiro, Brazil; Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Rosana Souza
authors.initials: RS
authors.lastname: Rodrigues
mesh_terms: D001706:Biopsy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005234:Fatty Liver / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007091:Image Processing, Computer-Assisted; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000175:diagnosis; D015203:Reproducibility of Results