title: Diffusion-weighted imaging (DWI) of the liver in assessing chronic liver disease: effects of the presence and the degree of ascites on ADC values.
abstract: OBJECTIVE
  The aim of this study was to determine the correlation between the liver and spleen apparent diffusion coefficient (ADC) values of patients with chronic liver disease and the presence and the degree of ascites.
  
  
  METHODS
  In this retrospective study, we assessed 107 patients with chronic liver disease and 39 control subjects who underwent upper abdominal MR imaging including echo-planar diffusion-weighted imaging (DWI). Among the 107 cirrhotic patients, 56 were classified as group 1, 25 as group 2, and 26 as group 3 according to the absence, the presence of minimal, and the presence of massive ascites, respectively. The scores of model for end-stage liver disease (MELD) were matched between groups as the standard reference. The liver ADC, spleen ADC, and normalized liver ADC values were compared between the control group and patients' groups.
  
  
  RESULTS
  Patients with massive ascites had significantly higher MELD score compared with the other groups. The MELD score was also significantly higher in patient groups than in control group. The liver and normalized liver ADCs of patients' groups were significantly lower than that of the control group. With some overlap among groups, the measured ADC values decreased as the amount of the ascites increased, and these relationships were statistically significant. Furthermore, compared to control group, patients with massive ascites had significantly higher spleen ADCs.
  
  
  CONCLUSIONS
  Our results indicate that the ADC value of the liver and spleen correlates with the presence and the degree of ascites in patients with chronic liver disease, and merits further study.
authors.affiliation: Department of Radiology, Turgut Ozal Medical Center, Inonu University School of Medicine, 44315, Malatya, Turkey. mdasagir2003@hotmail.com.
authors.forename: Aysegul Sagir
authors.initials: AS
authors.lastname: Kahraman
authors.affiliation: Department of Radiology, Private Malatya Hospital, Malatya, Turkey. k_bayram@hotmail.com.
authors.forename: Bayram
authors.initials: B
authors.lastname: Kahraman
authors.affiliation: Department of Radiology, Turgut Ozal Medical Center, Inonu University School of Medicine, 44315, Malatya, Turkey. zynpmaras@yahoo.com.
authors.forename: Zeynep Maras
authors.initials: ZM
authors.lastname: Ozdemir
authors.affiliation: Department of Radiology, Turgut Ozal Medical Center, Inonu University School of Medicine, 44315, Malatya, Turkey. ayseyazici@yahoo.com.
authors.forename: Cemile Ayse
authors.initials: CA
authors.lastname: Gormeli
authors.affiliation: Department of General Surgery, Inonu University School of Medicine, Malatya, Turkey. fatih.ozdemir@inonu.edu.tr.
authors.forename: Fatih
authors.initials: F
authors.lastname: Ozdemir
authors.affiliation: Department of Radiology, Turgut Ozal Medical Center, Inonu University School of Medicine, 44315, Malatya, Turkey. metin.dogan@inonu.edu.tr.
authors.forename: Metin
authors.initials: M
authors.lastname: Dogan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000473:pathology*; D016022:Case-Control Studies; D002908:Chronic Disease; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D017352:Echo-Planar Imaging; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013154:Spleen / Q000473:pathology*
keywords: ADC measurements; Ascites; Chronic liver disease; Diffusion-weighted MRI; Magnetic resonance imaging