Efficacy of diffusion-weighted magnetic resonance imaging in the evaluation of extrahepatic cholestasis-related hepatic fibrosis
Background/aim: To investigate the efficacy of diffusion-weighted magnetic resonance imaging (DWI) in the diagnosis and staging of fibrosis induced by experimental bile duct ligation (BDL). Materials and methods: Twenty-four rats were divided randomly into four groups: control, BDL - 3 days, BDL - 2 weeks, and BDL - 4 weeks. DWI was performed with b-values of 100 and 500 on the rats from control group at day zero, on the rats from the BDL - 3 days group at the end of day 3, on the rats from the BDL - 2 weeks group at the end of day 14, and on the rats from the BDL - 4 weeks at the end of day 28. Results: When fibrosis scores generated in all groups were evaluated together, a strong negative correlation was detected between fibrosis scores and apparent diffusion coefficient (ADC) values measured using b 100 and b 500. ADC values obtained using b 100 were found to be significantly higher compared to the fibrosis observed in both the BDL - 2 weeks and BDL - 4 weeks groups (P < 0.003 and P < 0.001, respectively). Conclusion: We think that DWI may be an alternative to liver biopsy for the diagnosis and staging of hepatic fibrosis with underlying extrahepatic cholestasis.
Efficacy of diffusion-weighted magnetic resonance imaging in the evaluation of extrahepatic cholestasis-related hepatic fibrosis
Background/aim: To investigate the efficacy of diffusion-weighted magnetic resonance imaging (DWI) in the diagnosis and staging of fibrosis induced by experimental bile duct ligation (BDL). Materials and methods: Twenty-four rats were divided randomly into four groups: control, BDL - 3 days, BDL - 2 weeks, and BDL - 4 weeks. DWI was performed with b-values of 100 and 500 on the rats from control group at day zero, on the rats from the BDL - 3 days group at the end of day 3, on the rats from the BDL - 2 weeks group at the end of day 14, and on the rats from the BDL - 4 weeks at the end of day 28. Results: When fibrosis scores generated in all groups were evaluated together, a strong negative correlation was detected between fibrosis scores and apparent diffusion coefficient (ADC) values measured using b 100 and b 500. ADC values obtained using b 100 were found to be significantly higher compared to the fibrosis observed in both the BDL - 2 weeks and BDL - 4 weeks groups (P < 0.003 and P < 0.001, respectively). Conclusion: We think that DWI may be an alternative to liver biopsy for the diagnosis and staging of hepatic fibrosis with underlying extrahepatic cholestasis.
___
- Rogoveanu I, Gheonea DI, Saftoiu A, Ciurea T. The role of imaging methods in identifying the causes of extrahepatic cholestasis. J Gastrointestin Liver Dis 2006; 15: 265–271.
- Slott PA, Liu MH, Tavoloni N. Origin, pattern and mechanism of bile duct proliferation following biliary obstruction in the rat. Gastroenterology 1990; 99: 466–477.
- Wanless IR, Nakashima E, Sherman M. Regression of human cirrhosis. Morphologic features and the genesis of incomplete septal cirrhosis. Arch Pathol Lab Med 2000; 124: 1599–1607.
- Arthur MJ. Reversibility of liver fibrosis and cirrhosis following treatment for hepatitis C. Gastroenterology 2002; 122: 1525– 1528.
- Veldhuijzen IK, Toy M, Hahné SJ, De Wit GA, Schalm SW, de Man RA, Richardus JH. Screening and early treatment of migrants for chronic hepatitis B virus infection is cost-effective. Gastroenterology 2010; 138: 522–530.
- Berg T, Sarrazin C, Hinrichsen H, Buggisch P, Gerlach T, Zachoval R, Zeuzem S. Does noninvasive staging of fibrosis challenge liver biopsy as a gold standard in chronic hepatitis C? Hepatology 2004; 39: 1456–1467.
- Afdhal NH, Nunes D. Evaluation of liver fibrosis: a concise review. Am J Gastroenterol 2004; 99: 1160–1174.
- Kugelmas M. Liver biopsy. Am J Gastroenterol 2004; 99: 1416– 1417.
- Bakan AA, Inci E, Bakan S, Gokturk S, Cimilli T. Utility of diffusion-weighted imaging in the evaluation of liver fibrosis. Eur Radiol 2012; 22: 682–687.
- Bammer R. Basic principles of diffusion-weighted imaging. Eur J Radiol 2003; 45: 169–184.
- Naganawa S, Kawai H, Fukatsu H, Sakurai Y, Aoki I, Miura S, Mimura T, Kanazawa H, Ishigaki T. Diffusion-weighted imaging of the liver: technical challenges and prospects for the future. Magn Reson Med Sci 2005; 4: 175–186.
- Charles-Edwards EM, de Souza NM. Diffusion-weighted magnetic resonance imaging and its application to cancer. Cancer Imaging 2006; 6: 135–143.
- Thoeny HC, De Keyzer F. Extracranial applications of diffusion-weighted magnetic resonance imaging. Eur Radiol 2007; 17: 1385–1393.
- Cheung JS, Fan SJ, Gao DS, Chow AM, Man K, Wu EX. Diffusion tensor imaging of liver fibrosis in an experimental model. J Magn Reson Imaging 2010; 32: 1141–1148.
- Koinuma M, Ohashi I, Hanafusa K, Shibuya H. Apparent diffusion coefficient measurements with diffusion-weighted magnetic resonance imaging for evaluation of hepatic fibrosis. J Magn Reson Imaging 2005; 22: 80–85.
- Luciani A, Vignaud A, Cavet M, Nhieu JT, Mallat A, Ruel L, Laurent A, Deux JF, Brugieres P, Rahmouni A. Liver cirrhosis: intravoxel incoherent motion MR imaging—pilot study. Radiology 2008; 249: 891–899.
- Taouli B, Chouli M, Martin AJ, Qayyum A, Coakley FV, Vilgrain V. Chronic hepatitis: role of diffusion-weighted imaging and diffusion tensor imaging for the diagnosis of liver fibrosis and inflammation. J Magn Reson Imaging 2008; 28: 89–95.
- Cemek M, Aymelek F, Büyükokuroğlu ME, Karaca T, Büyükben A, Yilmaz F. Protective potential of Royal Jelly against carbon tetrachloride induced-toxicity and changes in the serum sialic acid levels. Food Chem Toxicol 2010; 48: 2827–2832.
- Boyer JL. New perspectives for the treatment of cholestasis: lessons from basic science applied clinically. J Hepatol 2007; 46: 365–371.
- Montilla P, Cruz A, Padillo FJ, Tunez I, Gasson F. Melatonin versus vitamin E as protective treatment against oxidative stress after extra-hepatic bile duct ligation in rats. J Pineal Res 2001; 31: 138–144.
- Taouli B, Koh DM. Diffusion-weighted MR imaging of the liver. Radiology 2010; 254: 47–66.
- Taouli B, Vilgrain V, Dumont E, Daire JL, Fan B, Menu Y. Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences: prospective study in 66 patients. Radiology 2003; 226: 71–78.
- Ichikawa T, Haradome H, Hachiya J, Nitatori T, Araki T. Diffusion-weighted MR imaging with a single-shot echo- planar sequence: detection and characterization of focal hepatic lesions. AJR Am J Roentgenol 1998; 170: 397–402.
- Namimoto T, Yamashita Y, Sumi S, Tang Y, Takahashi M. Focal liver masses: characterization with diffusion-weighted echo- planar MR imaging. Radiology 1997; 204: 739–744.
- Amano Y, Kumazaki T, Ishihara M. Single-shot diffusion- weighted echo-planar imaging of normal and cirrhotic livers using a phased-array multicoil. Acta Radiol 1998; 39: 440–442.
- Aubé C, Racineux PX, Lebigot J, Oberti F, Croquet V, Argaud C, Calès P, Caron C. Diagnosis and quantification of hepatic fibrosis with diffusion weighted MR imaging: preliminary results. J Radiol 2004; 85: 301–306.
- Sandrasegaran K, Akisik FM, Lin C, Tahir B, Rajan J, Saxena R, Aisen AM. Value of diffusion-weighted MRI for assessing liver fibrosis and cirrhosis. AJR Am J Roentgenol 2009; 193: 1556–1560.
- Taouli B, Tolia AJ, Losada M, Babb JS, Chan ES, Bannan MA, Tobias H. Diffusion-weighted MRI for quantification of liver fibrosis: preliminary experience. AJR Am J Roentgenol 2007; 189: 799–806.
- Boulanger Y, Amara M, Lepanto L, Beaudoin G, Nguyen BN, Allaire G, Poliquin M, Nicolet V. Diffusion-weighted MR imaging of the liver of hepatitis C patients. NMR Biomed 2003; 16: 132–136.
- Lewin M, Poujol-Robert A, Boëlle PY, Wendum D, Lasnier E, Viallon M, Guéchot J, Hoeffel C, Arrivé L, Tubiana JM et al. Diffusion-weighted magnetic resonance imaging for the assessment of fibrosis in chronic hepatitis C. Hepatology 2007; 46: 658–465.
- Girometti R, Furlan A, Esposito G, Bazzocchi M, Como G, Soldano F, Isola M, Toniutto P, Zuiani C. Relevance of b-values in evaluating liver fibrosis: a study in healthy and cirrhotic subjects using two single-shot spin-echo echo-planar diffusion- weighted sequences. J Magn Reson Imaging 2008; 28: 411–419.
- Norris DG. The effects of microscopic tissue parameters on the diffusion weighted magnetic resonance imaging experiment. NMR Biomed 2001; 14: 77–93.
- Le Bihan D. Molecular diffusion, tissue microdynamics and microstructure. NMR Biomed 1995; 8: 375–386.
- Annet L, Materne R, Danse E, Jamart J, Horsmans Y, Van Beers BE. Hepatic flow parameters measured with MR imaging and Doppler US: correlations with degree of cirrhosis and portal hypertension. Radiology 2003; 229: 409–414.
- Annet L, Peeters F, Abarca-Quinones J, Leclercq I, Moulin P, Van Beers BE. Assessment of diffusion-weighted MR imaging in liver fibrosis. J Magn Reson Imaging 2007; 25: 122–128.