To what extent the DW-MRI and ADC value can be used in assessment of hepatic focal lesions in cirrhotic patients

Abstract

Aim: To assess the role of DW-MRI and ADC value in evaluation of hepatic focal lesions in cirrhotic patients compared to triphasic CT and dynamic MRI. Patients and methods: 164 cirrhotic patients with hepatic focal lesions were subjected to full clinical examination and laboratory evaluations. DW-MRI with ADC value measurement was done for all patients in addition to triphasic CT and dynamic MRI. The radiological diagnosis was correlated to pathological results in all patients. Results: 164 included cirrhotic patients (312 lesions), their mean age (57.7 ± 3.2). 206 lesions were diagnosed pathologically as malignant; hepatocellular carcinoma was the most common (83%), metastasis (32%) and cholangiocarcinoma (1.5%). 106 lesions were diagnosed pathologically as benign; hemangioma was the most common (61.3%), cirrhotic regeneration nodules (32.1%) and cysts (6.6%). The mean ADC values for malignant lesions were lower than those for benign lesions with significant P-value (0.007) and cutoff value 1.2 × 10−3 mm2/sec. DWI-MRI was more accurate in the assessment of HFLs (96.1% sensitivity, 98.1% specificity and 96.8% accuracy) than triphasic CT and dynamic MRI. Conclusion: DW-MRI with ADC value can be used in the assessment of HFLs in cirrhotic patients with comparable results to dynamic MRI and more accurate than the use of triphasic CT.

Keywords

• Diffusion MRI
• ADC value
• HFLs in cirrhotic patients