Skip to main content
Log in

Diffusion-weighted imaging (DWI) of the liver in assessing chronic liver disease: effects of the presence and the degree of ascites on ADC values

  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to determine the correlation between the liver and spleen apparent diffusion coefficient (ADC) values of patients with chronic liver disease and the presence and the degree of ascites.

Materials and method

In this retrospective study, we assessed 107 patients with chronic liver disease and 39 control subjects who underwent upper abdominal MR imaging including echo-planar diffusion-weighted imaging (DWI). Among the 107 cirrhotic patients, 56 were classified as group 1, 25 as group 2, and 26 as group 3 according to the absence, the presence of minimal, and the presence of massive ascites, respectively. The scores of model for end-stage liver disease (MELD) were matched between groups as the standard reference. The liver ADC, spleen ADC, and normalized liver ADC values were compared between the control group and patients’ groups.

Results

Patients with massive ascites had significantly higher MELD score compared with the other groups. The MELD score was also significantly higher in patient groups than in control group. The liver and normalized liver ADCs of patients’ groups were significantly lower than that of the control group. With some overlap among groups, the measured ADC values decreased as the amount of the ascites increased, and these relationships were statistically significant. Furthermore, compared to control group, patients with massive ascites had significantly higher spleen ADCs.

Conclusion

Our results indicate that the ADC value of the liver and spleen correlates with the presence and the degree of ascites in patients with chronic liver disease, and merits further study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Kamath PS, Wiesner RH, Malinchoc M, et al. (2001) A model to predict survival in patients with end-stage liver disease. Hepatology 33:464–470

    Article  CAS  PubMed  Google Scholar 

  2. Kamath PS, Kim WR, Advanced Liver Disease Study Group (2007) The model for end-stage liver disease (MELD). Hepatology 45:797–805

    Article  PubMed  Google Scholar 

  3. Ito K, Mitchell DG, Hann HW, et al. (1999) Viral-induced cirrhosis: grading of severity using MR imaging. Am J Roentgenol 173(3):591–596

    Article  CAS  Google Scholar 

  4. Saygili OB, Tarhan NC, Yildirim T, et al. (2005) Value of computed tomography and magnetic resonance imaging for assessing severity of liver cirrhosis secondary to viral hepatitis. Eur J Radiol 54(3):400–407

    Article  PubMed  Google Scholar 

  5. Moreau R, Delègue P, Pessione F, et al. (2004) Clinical characteristics and outcome of patients with cirrhosis and refractory ascites. Liver Int 24(5):457–464

    Article  PubMed  Google Scholar 

  6. Do RK, Chandarana H, Felker E, et al. (2010) Diagnosis of liver fibrosis and cirrhosis with diffusion-weighted imaging: value of normalized apparent diffusion coefficient using the spleen as reference organ. Am J Roentgenol 195(3):671–676. doi:10.2214/AJR.09.3448

    Article  Google Scholar 

  7. Qu JR, Li HL, Shao NN, et al. (2012) Additional diffusion-weighted imaging in the detection of new, very small hepatocellular carcinoma lesions after interventional therapy compared with conventional 3 T MRI alone. Clin Radiol 67(7):669–674

    Article  PubMed  Google Scholar 

  8. Le Moigne F, Durieux M, Bancel B, et al. (2012) Impact of diffusion-weighted MR imaging on the characterization of small hepatocellular carcinoma in the cirrhotic liver. Magn Reson Imaging 30(5):656–665

    Article  PubMed  Google Scholar 

  9. Koinuma M, Ohashi I, Hanafusa K, Shibuya H (2005) Apparent diffusion coefficient measurements with diffusion-weighted magnetic resonance imaging for evaluation of hepatic fibrosis. J Magn Reson Imaging 22(1):80–85

    Article  PubMed  Google Scholar 

  10. Taouli B, Koh DM (2010) Diffusion-weighted MR imaging of the liver. Radiology 254(1):47–66. doi:10.1148/radiol.09090021

    Article  PubMed  Google Scholar 

  11. Papanikolaou N, Gourtsoyianni S, Yarmenitis S, Maris T, Gourtsoyiannis N (2010) Comparison between two-point and four-point methods for quantification of apparent diffusion coefficient of normal liver parenchyma and focal lesions. Value of normalization with spleen. Eur J Radiol 73(2):305–309

    Article  PubMed  Google Scholar 

  12. Girometti R, Furlan A, Esposito G, et al. (2008) 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 28(2):411–419. doi:10.1002/jmri.21461

    Article  PubMed  Google Scholar 

  13. Nasu K, Kuroki Y, Sekiguchi R, Kazama T, Nakajima H (2006) Measurement of the apparent diffusion coefficient in the liver: is it a reliable index for hepatic disease diagnosis? Radiat Med 24(6):438–444

    Article  CAS  PubMed  Google Scholar 

  14. Haimerl M, Verloh N, Fellner C, et al. (2014) MRI-based estimation of liver function: Gd-EOB-DTPA-enhanced T1 relaxometry of 3T vs. the MELD score. Sci Rep 8(4):5621

    Google Scholar 

  15. Bülow R, Mensel B, Meffert P, et al. (2013) Diffusion-weighted magnetic resonance imaging for staging liver fibrosis is less reliable in the presence of fat and iron. Eur Radiol 23(5):1281–1287

    Article  PubMed  Google Scholar 

  16. Koh DM, Collins DJ (2007) Diffusion-weighted MRI in the body: applications and challenges in oncology. Am J Roentgenol 188(6):1622–1635

    Article  Google Scholar 

  17. Tosun M, Inan N, Sarisoy HT, et al. (2013) Diagnostic performance of conventional diffusion weighted imaging and diffusion tensor imaging for the liver fibrosis and inflammation. Eur J Radiol 82(2):203–207 (Epub 2012 Nov 2). doi:10.1016/j.ejrad.2012.09.009

    Article  PubMed  Google Scholar 

  18. Klasen J, Lanzman RS, Wittsack HJ, et al. (2013) Diffusion-weighted imaging (DWI) of the spleen in patients with liver cirrhosis and portal hypertension. Magn Reson Imaging 31(7):1092–1096 (Epub 2013 Jun 2). doi:10.1016/j.mri.2013.01.003

    Article  PubMed  Google Scholar 

  19. Yoshikawa T, Kawamitsu H, Mitchell DG, et al. (2006) ADC measurement of abdominal organs and lesions using parallel imaging technique. Am J Roentgenol 187(6):1521–1530

    Article  Google Scholar 

  20. Girometti R, Furlan A, Bazzocchi M, et al. (2007) Diffusion-weighted MRI in evaluating liver fibrosis: a feasibility study in cirrhotic patients. Radiol Med 112(3):394–408 (Epub 2007 Apr 20)

    Article  CAS  PubMed  Google Scholar 

  21. Chandarana H, Do RK, Mussi TC, et al. (2012) The effect of liver iron deposition on hepatic apparent diffusion coefficient values in cirrhosis. Am J Roentgenol 199(4):803–808

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Aysegul Sagir Kahraman.

Ethics declarations

Conflict of interest

The authors have not declared any conflict of interests.

Financial support

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kahraman, A.S., Kahraman, B., Ozdemir, Z.M. et al. Diffusion-weighted imaging (DWI) of the liver in assessing chronic liver disease: effects of the presence and the degree of ascites on ADC values. Abdom Radiol 41, 56–62 (2016). https://doi.org/10.1007/s00261-015-0613-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-015-0613-7

Keywords

Navigation