title: Intravoxel Incoherent Motion MR Imaging for Staging of Hepatic Fibrosis.
abstract: OBJECTIVE
  To determine the potential of intravoxel incoherent motion (IVIM) MR imaging for staging of hepatic fibrosis (HF).
  
  
  METHODS
  We searched PubMed and EMBASE from their inception to 31 July 2015 to select studies reporting IVIM MR imaging and HF staging. We defined F1-2 as non-advanced HF, F3-4 as advanced HF, F0 as normal liver, F1 as very early HF, and F2-4 as significant HF. Then we compared stage F0 with F1, F0-1 with F2-3, and F1-2 with F3-4 using IVIM-derived parameters (pseudo-diffusion coefficient D*, perfusion fraction f, and pure molecular diffusion parameter D). The effect estimate was expressed as a pooled weighted mean difference (WMD) with 95% confidence interval (CI), using the fixed-effects model.
  
  
  RESULTS
  Overall, we included six papers (406 patients) in this study. Significant differences in D* were observed between F0 and F1, F0-1 and F2-3, and F1-2 and F3-4 (WMD 2.46, 95% CI 0.83-4.09, P = 0.006; WMD 13.10, 95% CI 9.53-16.67, P < 0.001; WMD 14.34, 95% CI 10.26-18.42, P < 0.001, respectively). Significant differences in f were also found between F0 and F1, F0-1 and F2-3, and F1-2 and F3-4 (WMD 1.62, 95% CI 0.06-3.18, P = 0.027; WMD 5.63, 95% CI 2.74-8.52, P < 0.001; WMD 3.30, 95% CI 2.10-4.50, P < 0.001, respectively). However, D showed no differences between F0 and F1, F0-1 and F2-3, and F1-2 and F3-4 (WMD 0.05, 95% CI -0.01─0.11, P = 0.105; WMD 0.04, 95% CI -0.01─0.10, P = 0.230; WMD 0.02, 95% CI -0.02─0.06, P = 0.378, respectively).
  
  
  CONCLUSIONS
  IVIM MR imaging provides an effective method of staging HF and can distinguish early HF from normal liver, significant HF from normal liver or very early HF, and advanced HF from non-advanced HF.
authors.affiliation: Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong Province, China.|Graduate College, Southern Medical University, Guangzhou, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong Province, China.|Graduate College, Southern Medical University, Guangzhou, China.
authors.forename: Long
authors.initials: L
authors.lastname: Liang
authors.affiliation: Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong Province, China.
authors.forename: Yuhao
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong Province, China.|Graduate College, Southern Medical University, Guangzhou, China.
authors.forename: Zhouyang
authors.initials: Z
authors.lastname: Lian
authors.affiliation: Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong Province, China.
authors.forename: Wenbo
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong Province, China.
authors.forename: Changhong
authors.initials: C
authors.lastname: Liang
authors.affiliation: Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong Province, China.
authors.forename: Shuixing
authors.initials: S
authors.lastname: Zhang
mesh_terms: D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
references.citation: AJR Am J Roentgenol. 2015 Jul;205(1):22-32
references.pmid: 25905647
references.citation: Eur J Radiol. 1998 Feb;26(3):297-303
references.pmid: 9587760
references.citation: Eur Radiol. 2014 Aug;24(8):1998-2004
references.pmid: 24838795
references.citation: Dig Dis Sci. 2015 Sep;60(9):2825-31
references.pmid: 25972148
references.citation: Radiology. 1988 Aug;168(2):497-505
references.pmid: 3393671
references.citation: Am J Med. 2005 Aug;118(8):808-15
references.pmid: 16084169
references.citation: Hepatology. 2009 Apr;49(4):1335-74
references.pmid: 19330875
references.citation: Radiology. 2008 Dec;249(3):891-9
references.pmid: 19011186
references.citation: Radiology. 2013 Mar;266(3):920-9
references.pmid: 23220895
references.citation: J Magn Reson Imaging. 2007 Jan;25(1):122-8
references.pmid: 17154179
references.citation: J Magn Reson Imaging. 2015 May;41(5):1209-17
references.pmid: 25044653
references.citation: J Magn Reson Imaging. 2010 Mar;31(3):589-600
references.pmid: 20187201
references.citation: Magn Reson Med. 2010 Dec;64(6):1580-5
references.pmid: 20665824
references.citation: Acta Radiol. 2015 Dec;56(12):1428-36
references.pmid: 25414372
references.citation: Biomed Res Int. 2015;2015:874201
references.pmid: 25866819
references.citation: Radiology. 2014 Feb;270(2):444-53
references.pmid: 24126370
references.citation: Eur Radiol. 2014 Jul;24(7):1506-13
references.pmid: 24744198
references.citation: Magn Reson Imaging. 2014 Sep;32(7):860-6
references.pmid: 24832359
references.citation: Hepatology. 2003 May;37(5):972-4
references.pmid: 12717376
references.citation: Harefuah. 2015 Mar;154(3):204-7, 210, 209
references.pmid: 25962254
references.citation: J Magn Reson Imaging. 2012 Jul;36(1):159-67
references.pmid: 22334528
references.citation: Radiology. 2012 Oct;265(1):96-103
references.pmid: 22843768
references.citation: World J Gastroenterol. 2014 Dec 28;20(48):18131-50
references.pmid: 25561782
references.citation: PLoS One. 2014;9(12):e113846
references.pmid: 25436458
references.citation: J Magn Reson Imaging. 2006 Sep;24(3):637-45
references.pmid: 16888790
references.citation: J Comput Assist Tomogr. 2014 Jan-Feb;38(1):110-6
references.pmid: 24378888
references.citation: Radiology. 2004 Mar;230(3):652-9
references.pmid: 14990831
references.citation: J Magn Reson Imaging. 2015 Jul;42(1):204-10
references.pmid: 25223820
references.citation: J Magn Reson Imaging. 2008 Aug;28(2):411-9
references.pmid: 18666139
references.citation: J Magn Reson Imaging. 2015 Aug;42(2):331-9
references.pmid: 25384923
references.citation: Eur Radiol. 2015 Dec;25(12):3552-9
references.pmid: 25991478
references.citation: J Magn Reson Imaging. 2014 Feb;39(2):276-85
references.pmid: 23633178
references.citation: Eur Radiol. 2014 Aug;24(8):1914-22
references.pmid: 24788038
references.citation: Magn Reson Med. 2011 May;65(5):1437-47
references.pmid: 21287591
references.citation: Eur Radiol. 2016 Feb;26(2):539-46
references.pmid: 25991488
references.citation: World J Hepatol. 2015 Mar 27;7(3):607-15
references.pmid: 25848485
references.citation: Chin Med J (Engl). 2014;127(17):3082-7
references.pmid: 25189949
references.citation: J Magn Reson Imaging. 2005 Jul;22(1):80-5
references.pmid: 15971188
references.citation: J Magn Reson Imaging. 2013 Jul;38(1):148-53
references.pmid: 23239543
references.citation: Hepatology. 2007 Sep;46(3):658-65
references.pmid: 17663420
references.citation: Magn Reson Imaging. 2013 Jul;31(6):1017-21
references.pmid: 23598061
references.citation: AJR Am J Roentgenol. 2009 Dec;193(6):1556-60
references.pmid: 19933647
references.citation: AJR Am J Roentgenol. 2015 Jul;205(1):33-40
references.pmid: 25905762