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Purpose  This study was aimed to determine whether pure molecular-based diffusion coefficient ( D ) and perfusion-related diffusion parameters (perfusion fraction  f , perfusion-related diffusion coefficient  D* ) differ in healthy livers and fibrotic livers through intra-voxel incoherent motion (IVIM) MR imaging.    Material and Methods  17 healthy volunteers and 34 patients with histopathologically confirmed liver fibrosis patients (stage 1 = 14, stage 2 = 8, stage 3& 4 = 12, METAVIR grading) were included. Liver MR imaging was performed at 1.5-T. IVIM diffusion weighted imaging sequence was based on standard single-shot DW spin echo-planar imaging, with ten  b  values of 10, 20, 40, 60, 80, 100, 150, 200, 400, 800 sec/mm 2  respectively. Pixel-wise realization and regions-of-interest based quantification of IVIM parameters were performed.    Results    D, f , and  D*  in healthy volunteer livers and patient livers were 1.096±0.155 vs 0.917±0.152 (10 −3  mm 2 /s, p = 0.0015), 0.164±0.021 vs 0.123±0.029 (p<0.0001), and 13.085±2.943 vs 9.423±1.737 (10 −3  mm 2 /s, p<0.0001) respectively, all significantly lower in fibrotic livers. As the fibrosis severity progressed,  D ,  f , and  D*  values decreased, with a trend significant for  f  and  D* .    Conclusion  Fibrotic liver is associated with lower pure molecular diffusion, lower perfusion volume fraction, and lower perfusion-related diffusion. The decrease of  f  and  D*  in the liver is significantly associated liver fibrosis severity.

plos one

Decreases in Molecular Diffusion, Perfusion Fraction and Perfusion-Related Diffusion in Fibrotic Livers: A Prospective Clinical Intravoxel Incoherent Motion MR Imaging Study