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Intravoxel Incoherent Motion Diffusion Weighted MR Imaging at 3.0 T: Assessment of Steatohepatitis and Fibrosis Compared with Liver Biopsy in Type 2 Diabetic Patients
Authors:Daniella Braz Parente  Fernando Fernandes Paiva  Jaime Araújo Oliveira Neto  Lilian Machado-Silva  Fatima Aparecida Ferreira Figueiredo  Valeria Lanzoni  Carlos Frederico Ferreira Campos  Pedro Emmanuel Alvarenga Americano do Brasil  Marilia de Brito Gomes  Renata de Mello Perez  Rosana Souza Rodrigues
Affiliation:1D’Or Institute for Research and Education, Rio de Janeiro, Brazil;2Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;3University of the State of Rio de Janeiro, Rio de Janeiro, Brazil;4Institute of Physics of São Carlos, University of São Paulo, São Carlos, Brazil;5Federal University of São Paulo, São Paulo, Brazil;University of Modena & Reggio Emilia, ITALY
Abstract:ObjectiveTo evaluate the capability of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) to assess steatohepatitis and fibrosis determined by histopathology in type 2 diabetic patients.MethodsFifty-nine type 2 diabetic patients (49 women, 10 men; mean age, 54 ± 9 years) were submitted to liver biopsy for the evaluation of non-alcoholic fatty liver disease (NAFLD) and underwent DWI on a 3.0T MR system using 10 b values. Institutional approval and patient consent were obtained. Pure molecular-based (D), perfusion-related (D*), and vascular fraction (f) were calculated using a double exponential model and least squares curve fitting. D, D*, and f were compared between patients with and without steatohepatitis and between patients with and without fibrosis. The variables were compared by using the Ranksum test and Student t-test.ResultsSteatohepatitis was observed in 22 patients and fibrosis in 16 patients. A lower D median (0.70 s/mm2 vs. 0.83 s/mm2, p<0.05) and a lower D* median (34.39 s/mm2 vs. 45.23 s/mm2, p<0.05) were observed among those with steatohepatitis. A lower D median (0.70 s/mm2 vs. 0.82 s/mm2, p<0.05) and a lower D* median (35.01 s/mm2 vs. 44.76 s/mm2, p=0.05) were also observed among those with fibrosis.ConclusionIVIM-DWI has the potential to aid in the characterization of steatohepatitis and fibrosis.
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