MRI-based estimation of liver function by intravoxel incoherent motion diffusion-weighted imaging

Area of Science:

• Radiology and Medical Imaging
• Hepatology
• Biophysics

Background:

• Assessing hepatic functional reserve is crucial for managing liver disease.
• Current methods for evaluating liver function can be invasive or limited.
• Intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) offers a non-invasive approach to probe tissue microstructural and microcirculatory properties.

Purpose of the Study:

• To investigate the utility of IVIM DWI in evaluating hepatic functional reserve.
• To correlate IVIM-derived parameters with the Child-Pugh classification of liver disease severity.

Main Methods:

• IVIM DWI with 10 b values was performed on 70 liver cirrhosis patients and 60 healthy controls.
• Patients were stratified into Child-Pugh classes A, B, and C.
• Pure molecular diffusion (D), pseudo-diffusion (D*), perfusion fraction (f), and apparent diffusion coefficient (ADC) were calculated.

Main Results:

• IVIM parameters (D*, f, ADC) were significantly lower in liver cirrhosis patients compared to controls.
• These parameters showed a significant decrease with increasing Child-Pugh scores.
• D* and f values demonstrated strong inverse correlations with Child-Pugh scores (r=-0.423, r=-0.620).
• Areas under the curve for D* and f ranged from 0.67-0.90 and 0.78-0.89, respectively, indicating good diagnostic performance.

Conclusions:

• IVIM DWI is a potentially valuable non-invasive imaging biomarker for assessing liver function.
• IVIM parameters can effectively reflect the severity of liver disease and hepatic functional reserve.
• This technique may aid in the clinical management of patients with liver cirrhosis.