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Diffusion‐weighted magnetic resonance imaging for the assessment of fibrosis in chronic hepatitis C
Author(s) -
Lewin Maïté,
PoujolRobert Armelle,
Boëlle PierreYves,
Wendum Dominique,
Lasnier Elisabeth,
Viallon Magalie,
Guéchot Jérôme,
Hoeffel Christine,
Arrivé Lionel,
Tubiana JeanMichel,
Poupon Raoul
Publication year - 2007
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.21747
Subject(s) - medicine , magnetic resonance elastography , magnetic resonance imaging , liver biopsy , gold standard (test) , fibrosis , gastroenterology , receiver operating characteristic , liver fibrosis , diffusion mri , effective diffusion coefficient , nuclear medicine , biopsy , chronic hepatitis , elastography , radiology , ultrasound , virus , virology
Liver biopsy is the gold standard for assessing fibrosis but has several limitations. We evaluated a noninvasive method, so‐called diffusion‐weighted magnetic resonance imaging (DWMRI), which measures the apparent diffusion coefficient (ADC) of water, for the diagnosis of liver fibrosis in patients with chronic hepatitis C virus (HCV). We analyzed 20 healthy volunteers and 54 patients with chronic HCV (METAVIR: F0, n = 1; F1, n = 30; F2, n = 8; F3, n = 5; and F4, n = 10) prospectively included. Patients with moderate‐to‐severe fibrosis (F2‐F3‐F4) had hepatic ADC values lower than those without or with mild fibrosis (F0‐F1; mean: 1.10 ± 0.11 versus 1.30 ± 0.12 × 10 −3 mm 2 /s) and healthy volunteers (mean: 1.44 ± 0.02 × 10 −3 mm 2 /s). In discriminating patients staged F3‐F4, the areas under the receiving operating characteristic curves (AUCs) were 0.92 (±0.04) for magnetic resonance imaging (MRI), 0.92 (±0.05) for elastography, 0.79 (±0.08) for FibroTest, 0.87 (±0.06) for the aspartate aminotransferase to platelets ratio index (APRI), 0.86 (±0.06) for the Forns index, and 0.87 (±0.06) for hyaluronate. In these patients, the sensitivity, specificity, positive predictive value, and negative predictive value were 87%, 87%, 72%, and 94%, respectively, with an ADC cutoff level of 1.21 × 10 −3 mm 2 /s. In discriminating patients staged F2‐F3‐F4, the AUC values were 0.79 (±0.07) for MRI, 0.87 (±0.05) for elastography, 0.68 (±0.09) for FibroTest, 0.81 (±0.06) for APRI, 0.72 (±0.08) for the Forns index, and 0.77 (±0.06) for hyaluronate. Conclusion: This preliminary study suggests that DWMRI compares favorably with other noninvasive tests for the presence of significant liver fibrosis. (H EPATOLOGY 2007.)