Objective: To evaluate the diagnostic efficacy of intravoxel incoherent motion (IVIM) parameters in hepatitis B virus (HBV)-induced hepatic fibrosis using different calculation methods and to investigate histopathologic origins.
Materials and methods: Liver biopsies from 37 prospectively recruited chronic hepatitis B patients were obtained. Twelve b-value (0-1000 s/mm^{2}) diffusion-weighted imaging (DWI) was performed with a 1.5 T scanner and was followed by blinded percutaneous liver biopsy. All biopsy specimens were evaluated with Ishak staging, and the microvascular density (MVD) was calculated. Patients were classified as having no/mild (F0-1), moderate (F2-3), or marked (F4-5) fibrosis. Pseudodiffusion (D*), the perfusion fraction (f), and the apparent diffusion coefficient (ADC) were calculated using all b-values, while true diffusion (D) was calculated using all b-values [D_{0-1000}] and b-values greater than 200 s/mm^{2} [D_{200}_{-}_{1000}]. Three concentric regions of interest (ROIs) (5, 10, and 20 mm) centered on the biopsy site were used.
Results: D* was correlated with the MVD (p = 0.015, Pearson’s r = 0.415), but f was not (p = 0.119). D_{0-1000} was inversely correlated with Ishak stage (p = 0.000, Spearman’s r_{s} = – 0.685) and was significantly decreased in all the fibrosis groups; however, only the no/mild and marked fibrosis groups had significantly different D_{200-1000} values. A pairwise comparison of receiver operating characteristic (ROC) curves of D_{0-1000} and D_{200-1000} showed significant differences (p = 0.039). D* was the best at discriminating early fibrosis (AUC = 0.861), while the ADC best discriminated advanced fibrosis (AUC = 0.964).
Conclusion: D* was correlated with the MVD and is a powerful parameter to discriminate early hepatic fibrosis. D significantly decreased with advanced fibrosis stage when using b-values less than 200 s/mm^{2} in calculations.
【저자키워드】 HBV, Liver fibrosis, IVIM, Perfusion fraction, Pseudodiffusion, True diffusion.,