Liver Lobe-based Magnetic Resonance Diffusion Weighted Imaging Using Multiple B Values In Patients With Hepatitis B Related Liver Cirrhosis: Association With The Presence And Child-pugh Class Of Cirrhosis

Objective: To determine the associations of liver lobe-based magnetic resonance diffusion weighted imaging(DWI) using multiple b values with presence and Child-Pugh class of cirrhosis in patients with hepatitis B.Material and Methods: Seventy-four cirrhotic patients with hepatitis B and 25 healthy volunteers underwent DWI with b values of 0, 500, 800 and 1000 sec/mm2. Apparent diffusion coefficients of individual liver lobes for b(0,500), b(0,800) or b(0,1000) were derived from the signal intensity averaged across images obtained with b values of 0 and 500 sec/mm2, of 0 and 800 sec/mm2, or of 0 and 1000 sec/mm2, respectively; and Apparent diffusion coefficients(ADCs) of left lateral liver lobe(LLL), left medial liver lobe(LML), right liver lobe(RL) and caudate lobe(CL) for b(0,500), b(0,800) or b(0,1000) were analyzed statistically to evaluate cirrhosis.Results: ADCs for b(0,500), b(0,800) and b(0,1000) were inversely correlated with Child-Pugh class in LLL, LML, RL and CL(r =-0.35 to-0.60, all P < 0.05) except ADC for b(0,1000) in LML(r =-0.17, P > 0.05). Among parameters, ADC for b(0,500) in LLL could best differentiate normal liver from cirrhosis with an area under receiver operating characteristic curve(AUC) of 0.989. ADC for b(0,800) in RL could best distinguish Child-Pugh Class A from B–C and A–B from C with AUCs of 0.732 to 0.747.Conclusions: Liver lobe-based apparent diffusion coefficients for b(0,500), b(0,800) tend to be associated with presence and Child-Pugh class of cirrhosis. Apparent diffusion coefficients for b(0,500) in LLL, and for b(0,800) in RL can identify the presence and severity of cirrhosis, respectively.