The Value Of MR IVIM-DWI And IDEAL-IQ In Evaluating The Degree Of Liver Fibrosis Of Chronic Hepatitis B

BackgroundChina is a high incidence area of chronic viral hepatitis,Chronic hepatitis B is the main cause of liver fibrosis.If there is no effective treatment,liver fibrosis will eventually progress to irreversible cirrhosis.There are more methods for clinical detection of liver fibrosis.However,there are many defects in the liver biopsy.Ultrasound elastography FibroScan is not suitable for patients with ascites,narrower intercostal gaps and obesity.The ADC value of magnetic resonance diffusion weighted imaging was limited in evaluating the ability of liver fibrosis.The theory of incoherent motion in voxel can be used to distinguish Brown movement and capillary microcirculation in tissues.Therefore,IVIM imaging is more likely to diagnose and evaluate liver fibrosis.PurposeThe objective is to optimize the technical parameters of 3.0T MRI IVIM liver imaging and to analyze the correlation of D,D^*and f value to the degree of liver fibrosis in patients with CHB.The purpose of this study is to investigate the value of IVIM DWI in the assessment of liver fibrosis in patients with chronic hepatitis B.Material and methods81 cases of patients with chronic hepatitis B liver fibrosis were divided into the mild liver fibrosis group,the moderate liver fibrosis group and the severe liver fibrosis group according to liver biopsy pathology and selected 22 healthy volunteers as control group.3.0T superconducting magnetic resonance,8 channel phased array of abdominal surface coils,and breathing door control technique are used.The participants were examined by magnetic resonance T1WI,fs-T2WI plain scan and IVIM-DWI et al.The scanning data is transmitted to the GE ADW4.5 post processing workstation.The difference of D,D^*and f value between the normal control group and the liver fibrosis group and between the liver fibrosis groups were statistically analyzed.ResultsWith the progression of liver fibrosis,the D,D^*and f value of liver were gradually reduced.There was signicficant difference in D,D^*and f value between the normal control group and the liver fibrosis group.There was signicficant difference in D value between the mild liver fibrosis group and the moderate liver fibrosis group,the mild liver fibrosis group and the severe liver fibrosis group,but there was not signicficant difference between the moderate liver fibrosis group and the severe liver fibrosis group.There was signicficant difference in D^*value between the liver fibrosis groups.There was signicficant difference in f value between the mild liver fibrosis group and the moderate liver fibrosis group,the mild liver fibrosis group and the severe liver fibrosis group,but there was not signicficant difference between the mild liver fibrosis group and the moderate liver fibrosis group.The D,D^*and f values in normal control group and liver fibrosis group respectively were?0.540±0.030?×10^-3mm²/s and?0.422±0.054?×10^-3mm²/s,?0.381±0.025?×10^-1mm²/s and?0.321±0.047?×10^-1mm²/s,?0.252±0.004?and?0.231±0.012?.The D,D^*and f values in the mild liver fibrosis group respectively were?0.489±0.026?×10^-3mm²/s,?0.349±0.039?×10^-1mm²/s and?0.237±0.007?;The D,D^*and f values in the moderate liver fibrosis group respectively were?0.401±0.031?×10^-3mm²/s,?0.319±0.036?×10^-1mm²/s and?0.235±0.006?.The D,D^*and f values in the severe liver fibrosis group respectively were?0.370±0.045?×10^-3mm²/s,?0.269±0.053?×10^-1mm²/s and?0.208±0.011?.ConclusionThe parameters D,D^*and f value of MR IVIM-DWI can approximately reflect the severity of liver fibrosis in patients with chronic hepatitis B,has potential value in clinical application,especially can be used for the noninvasive assessment of liver fibrosis in the early stage.Background Many studies have shown that liver fibrosis caused by CHB is often associated with iron overload.Hepatic irondeposition may be a synergistic risk factor for liver fibrosis in patients with chronic viral hepatitis B,and may also affect the therapeutic effect of viral hepatitis.There are also many studiesfound that hepatic irondeposition was significantly associated with the degree of liver fibrosis.R2* value is often used as a reliable indicator of Hepatic iron concentration?HIC?.The quantitative information such as R2* value can be obtained by using IDEAL-IQ.Based on this technique,IDEAL-IQ has the potentiality to distinguish the degree of liver fibrosis.Purpose The purpose of this study was to discuss the clinical value of R2* value of IDEAL-IQ sequence for quantitative assessment and stage of liver fibrosis in patients with CHB.Material and methods Consecutive patients who were referred for liver fibrosis caused by CHB and volunteers were recruited at People's Hospital of Henan Province from January 2016 to March 2017 in the study.The staging and grouping of liver fibrosis were performed according to the method of Scheuer.A total of 55 patients with HBV liver fibrosis were selected,including S1 phase?21 cases?,S2 phase?13 cases?,S3 phase?10 cases?,and S4 phase?11 cases?.S1 was defined as the mild liver fibrosis group,and S2 and S3 were defined as the moderate liver fibrosis,and S4 was defined as the severe liver fibrosis group.In addition,20 healthy volunteers were selected as control group.All participants underwent MRI examinations on a 3.0T MR imager.The scanning sequences consist of several types,such as IDEAL-IQ.The data was transferred to the GE ADW 4.5 post-processing station,and the built-in software automatically created R2* map.We selected totally nine the regions of interest?ROI?on the reconstructed R2* map,and measured their R2* values.The final R2* values were the average of all nine ROIs.The difference of R2* value between the normal control group and the liver fibrosis group and between the liver fibrosis groups were statistically analyzed.In addition,the correlation between liver fibrosis group and liver R2* value was analyzed.Results The R2* value in normal control group and liver fibrosis group respectively were?29.24±1.84?Hz and?31.19±2.10?Hz.The R2* values in mild liver fibrosis group,moderate liver fibrosis group and severe liver fibrosis group were?29.90±1.65?Hz,?31.28±1.80?Hz and?33.47±1.45?Hz,respectively.With the progression of liver fibrosis,the R2* values of liver were gradually increased.There was a significant difference in R2* value between the normal control group and the liver fibrosis group.One-way ANOVA with Bonferroni correction for multigroup comparisons showed that the R2* value could distinguish different degrees of liver fibrosis.There was positive correlation between R2* value and the stage of liver fibrosis.Conclusion R2* value increases in fibrotic livers caused by CHB comparing to healthy livers and increases as the progress of pathological stage develops.The quantitative parameter R2* obtained by IDEAL-IQ sequence can identify accurately a fibrotic or normal liver and evaluate different degrees of liver fibrosis.