Liver lobe-based magnetic resonance diffusion-weighted imaging using multiple b values in patients with hepatitis B-related liver cirrhosis: association with the liver disease severity according to the Child-Pugh class

OBJECTIVE:To determine the associations of liver lobe-based magnetic resonance diffusion-weighted imaging findings using multiple b values with the presence and Child-Pugh class of cirrhosis in patients with hepatitis B.METHODS:Seventy-four cirrhotic patients with hepatitis B and 25 healthy volunteers underwent diffusion-weighted imaging using b values of 0, 500, 800 and 1000 sec/mm². The apparent diffusion coefficients of individual liver lobes for b_(0,500), b_(0,800) and b_(0,1000) were derived from the signal intensity averaged across images obtained using b values of 0 and 500 sec/mm², 0 and 800 sec/mm², or 0 and 1000 sec/mm², respectively, and were statistically analyzed to evaluate cirrhosis.RESULTS:The apparent diffusion coefficients for b_(0,500), b_(0,800) and b_(0,1000) inversely correlated with the Child-Pugh class in the left lateral liver lobe, the left medial liver lobe, the right liver lobe and the caudate lobe (r=–0.35 to –0.60, all p<0.05), except for the apparent diffusion coefficient for b_(0,1000) in the left medial liver lobe (r=–0.17, p>0.05). Among these parameters, the apparent diffusion coefficient for b_(0,500) in the left lateral liver lobe best differentiated normal from cirrhotic liver, with an area under the receiver operating characteristic curve of 0.989. The apparent diffusion coefficient for b_(0,800) in the right liver lobe best distinguished Child-Pugh class A from B–C and A–B from C, with areas under the receiver operating characteristic curve of 0.732 and 0.747, respectively.CONCLUSION:Liver lobe-based apparent diffusion coefficients for b_(0,500) and b_(0,800) appear to be associated with the presence and Child-Pugh class of liver cirrhosis.