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Keywords:
Abdomen, MR-Diffusion/Perfusion, MR, Diagnostic procedure
Authors:
T. L. Harada, K. Saito, J. Mastubayashi, N. Yoshimura, Y. Araki, K. Sugimoto, T. Nagao, S. Akata, K. Tokuuye; Tokyo/JP
DOI:
10.1594/ecr2015/C-1098
Conclusion
- LMR was more useful tool than ADC value to evaluate fibrosis grade.
- ADC value was not useful to evaluate the liver fibrosis grade.
- This study revealed no correlation between ADC value and fibrosis grade.
Discussion
ADC value
This study revealed no correlation between ADC value and fibrosis grade,
despite several papers reported that significant correlation was observed between ADC value and the liver fibrosis grade(8).
On the other hand, few paper reported no correlation(9).
The reasons why there were no correlation between liver fibrosis and ADC value may be as follows.
- Direct comparison in this study (the region of measuring ADC value and area of evaluating pathology was almost same) was the method different from previous reports.
- Underlying condition of liver like followings: fatty infiltration,
iron deposition,
etc.
Direct comparison between ADC value and pathological finding at the almost same area.
- (Advantage)
- Resected specimen is large enough for pathological evaluation.
- Direct comparison can minimize the bias (portal perfusion,
etc.) (4,10)
- (Disadvantage)
- The region where was near the tumor may be influenced by tumor perfusion.
- However,
in our study,
ADC measured on the different segment additionally showed no significant differences from the original one.
Underlying condition of liver in this study
- ADC value decreased on fatty liver in previous study.(11)
- 33 patients (3７%) received chemotherapy before operation,
and chemotherapy may increase the number of patient with fatty liver or sinusoidal dilatation.
- Hemosiderin deposition decreases ADC value decreased on liver.(T2 shortnnening effect on liver parenchyma was shown in some patients in this study.)
Liver-to muscle ratio (LMR)
LMR showed the significant difference between F0-2 and F3-4.
Therefore,
LMR was more useful tool than ADC value to evaluate cirrhosis in this study.
(Advantage of LMR)
-No influence from perfusion effect.
-Possible to evaluate lateral segment where is near heart.
(Disadvantage of LMR)
-contrast media is necessary.
Limitation
- Perfusion effect might be included in this study,
because we used b-value of 100 mm2/s.
- Small numbers of F3-4 (especially in Gd-EOB-DTPA-enhanced MRI)
- Retrospective study
