Doaa M. Emara

Is diffusion weighted imaging adding value in diagnosis of focal hepatic lesions? Experience in 50 patients

Abstract Introduction Diffusion weighted imaging (DWI) offers molecular information that complements the morphologic information obtained with conventional magnetic resonance imaging (MRI) and can reflect the functions and structures of the body without trauma. Aim of the work To assess the role of DWI as a routine sequence in a MRI study to help in differentiating liver lesions. Patients and methods The study included 50 patients referred to do a MRI study to diagnose and/or to confirm the ultrasonographic or CT findings of focal hepatic lesions. The examination was done on 1.5T superconducting magnet MRI machines; Philips Gyroscan Intera version 12.1.1.2 (Best, The Netherlands) and Siemens Magnetom Avanto (Erlangen, Germany) machine. Results All studied patients had a focal hepatic lesion either on top of cirrhotic liver or non cirrhotic liver. DWI was found to be helpful with the routine MRI sequences to reach the diagnosis. The final diagnosis was confirmed by histopathological examination or follow up. A cutoff value of ADC for benign lesions was found to be 1.25 × 10−3 mm2/s. Conclusions DWI should be included as a basic sequence in the routine MRI study of the liver as it helps in diagnosis and so reaching a final diagnosis or at least trying to narrow the list of differential diagnosis.

Utility of diffusion weighted imaging (DWI) in assessment of liver fibrosis

Abstract Objectives: hepatic fibrosis occurs due to chronic liver injury. Early fibrosis can be reversed by treatment with specific antifibrotic therapy in addition to removal of the cause if possible, that is why, identification of the early liver fibrosis is important. MRI DWI is a non-invasive non-contrast imaging technique which help in diagnosis of different stages of hepatic fibrosis. Aim of the work: was to study the predictive value of diffusion weighted MRI for assessing liver fibrosis in comparison to liver biopsy in chronic hepatitis C virus patients. Methods: all the studied cases were subjected to the followings: (1) History and laboratory examination (PCR for HCV and liver function tests). (2) MRI DWI and post processing ADC map. (3) Percutaneous liver biopsy in cases with HCV for histopathological examination to assess the stage of fibrosis. Results: this study was carried out on 75 subjects, divided into two group, 50 cases and 25 controls, the mean age in the two studied groups was 36.5 ± 9.32 and 35.8 ± 6.75 respectively in patients and control. ADC of both liver and spleen showed a highly significant increase in the control than in the cases with mean liver ADC in the control group = 2.3 ± 0.25. There was a significant negative correlation between the mean ADC of the liver, spleen and the stage of liver fibrosis.