Role of Diffusion MRI in Assessing Liver Fibrosis in viral Hepatitis C Patients

Liver fibrosis results from excessive accumulation of extracellular matrix in response to chronic liver inflammation that has different causes at which hepatitis C viral infection represents the most common cause in Egypt.And although Liver biopsy represents the current gold standard diagnostic tool for liver fibrosis and cirrhosis it can’t be used as population based screening test for primary diagnosis of the disease or for follow up of treatment results as it is an invasive technique which has multiple drawbacks.Multiple Non invasive imaging modalities were used to some extent to diagnose liver fibrosis at which ultrasonography is the most commonly used. CT&MRI also can detect the altered morphology of cirrhotic liver. other recent modalities also used as DW-MRI,MR-ellastography Our study included 30 patients with chronic viral hepatitis C&9 healthy controls.28 of them underwent liver biopsy and histopathologically staged according to Ishak scoring system the other two patients were cirrhotic.DW- MRI were performed on all subjects (patients &control) using multiple b values of 200, 500, 700 and 1000 s/mm2 &Mean ADC values of liver were measured at for the four different b values. There was significant negative correlation between mean ADC and fibrosis stage for all examined b values at which best degree of negative correlation achieved with b-value 700 s/mm2.Using ROC analysis, mean hepatic ADC is a significant predictor of stage ≥F3 versus stage ≤F2 with best predictive b-value700 s/mm2. Finally, we can conclude that, DW-MRI with measuring the mean hepatic ADC values can be used to quantify liver fibrosis accurately as a promising technique with recommendable b-value 700 s/mm.