Diffusion tensor magnetic resonance imaging in the grading of liver fibrosis associated with congenital ductal plate malformations
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Faculty of Medicine, Mansoura University, Egypt
Mansoura University Children Hospital, Egypt
Submission date: 2022-12-08
Final revision date: 2023-01-11
Acceptance date: 2023-01-29
Publication date: 2023-03-08
Pol J Radiol, 2023; 88: 135-140
Liver biopsy is still the standard method for the diagnosis of ductal plate malformations (DPM). However, it is an invasive tool. Magnetic resonance imaging (MRI) has shown its accuracy in the diagnosis of this pathology. Herein, a study was conducted to elucidate the role of diffusion MRI parameters in predicting the degree of hepatic fibrosis.

Material and methods:
This prospective study included 29 patients with DPM and 20 healthy controls. Both groups underwent diffusion tensor magnetic resonance imaging (DT-MRI), and its parameters were compared between patients and controls, and then they were correlated with the degree of liver fibrosis in the patient group.

All patients with DPM, whatever its type, expressed a significantly lower hepatic apparent diffusion coefficient (ADC) compared to controls. However, fractional anisotropy (FA) showed no significant difference between them. The ADC value of 1.65 × 10-3 mm2/s had sensitivity and specificity of 82.1% and 90%, respectively, in differentiating DPM patients from healthy controls. It was evident that patients with higher fibrosis grades had significantly lower hepatic ADC, indicating a negative correlation between ADC and the grade of hepatic fibrosis; rs = –0.901, p < 0.001.

DT-MRI showed good efficacy in the diagnosis of congenital DPM. Moreover, ADC could be applied to monitor the degree of liver fibrosis rather than the invasive liver biopsy. No significant correlation was noted between the FA and the grades of liver fibrosis.

Lewis J. Pathology of fibropolycystic liver diseases. Clin Liver Dis (Hoboken) 2021; 17: 238-243.
Veigel MC, Prescott-Focht J, Rodriguez MG, et al. Fibropolycystic liver disease in children. Pediatr Radiol 2009; 39: 317-327; quiz 420-421.
Mamone G, Carollo V, Cortis K, et al. Magnetic resonance imaging of fibropolycystic liver disease: the spectrum of ductal plate malformations. Abdom Radiol (NY) 2019; 44: 2156-2171.
Brancatelli G, Federle MP, Vilgrain V, et al. Fibropolycystic liver disease: CT and MR imaging findings. Radiographics 2005; 25: 659-670.
Safwan M, Ramachandran P, Vij M, et al. Impact of ductal plate malformation on survival with native liver in children with biliary atresia. Pediatr Surg Int 2015; 31: 837-843.
Palomba E, Maggioni M, Viero G, et al. Congenital hepatic fibrosis as a cause of recurrent cholangitis: a case report and review of the literature. Livers 2021; doi: 10.3390/livers1030012.
de Lédinghen V, Le Bail B, Trillaud H, et al. Case report: secondary biliary cirrhosis possibly related to congenital hepatic fibrosis. Evidence for decreased number of portal branch veins and hypertrophic peribiliary vascular plexus. J Gastroenterol Hepatol 1998; 13: 720-724.
Feng JY, Chen L, Ma YY, et al. Role of a liver pathology standardized scoring system in the diagnosis of congenital biliary atresia and its relationship with prognosis. Zhonghua Bing Li Xue Za Zhi 2019; 48: 755-761.
Midia M, Odedra D, Shuster A, et al. Predictors of bleeding complications following percutaneous image-guided liver biopsy: a scoping review. Diagn Interv Radiol 2019; 25: 71-80.
Krausé D, Cercueil JP, Dranssart M, et al. MRI for evaluating congenital bile duct abnormalities. J Comput Assist Tomogr 2002; 26: 541-552.
Shamir SB, Kurian J, Kogan-Liberman D, Taragin BH. Hepatic imaging in neonates and young infants: state of the art. Radiology 2017; 285: 763-777.
McDonald N, Eddowes PJ, Hodson J, et al. Multiparametric magnetic resonance imaging for quantitation of liver disease: a two-centre cross-sectional observational study. Sci Rep 2018; 8: 9189. doi: 10.1038/s41598-018-27560-5.
Ajmera VH, Liu A, Singh S, et al. Clinical utility of an increase in magnetic resonance elastography in predicting fibrosis progression in nonalcoholic fatty liver disease. Hepatology 2020; 71: 849-860.
Soares JM, Marques P, Alves V, Sousa N. A hitchhiker’s guide to diffusion tensor imaging. Front Neurosci 2013; 7: 31. doi: 10.3389/fnins.2013.00031.
Beaulieu C. The basis of anisotropic water diffusion in the nervous system – a technical review. NMR Biomed 2002; 15: 435-455.
Hu XR, Cui XN, Hu QT, Chen J. Value of MR diffusion imaging in hepatic fibrosis and its correlations with serum indices. World J Gastroenterol 2014; 20: 7964-7970.
Kwee TC, Takahara T, Koh DM, et al. Comparison and reproducibility of ADC measurements in breathhold, respiratory triggered, and free-breathing diffusion-weighted MR imaging of the liver. J Magn Reson Imaging 2008; 28: 1141-1148.
Liu B, Cai J, Zhu J, et al. Diffusion tensor imaging for evaluating biliary atresia in infants and neonates. PLoS One 2016; 11: e0168477. doi: 10.1371/journal.pone.0168477.
Kim J, Yoon H, Lee MJ, et al. Clinical utility of mono-exponential model diffusion weighted imaging using two b-values compared to the bi- or stretched exponential model for the diagnosis of biliary atresia in infant liver MRI. PLoS One 2019; 14: e0226627. doi: 10.1371/journal.pone.0226627.
Ishak K, Baptista A, Bianchi L, et al. Histological grading and staging of chronic hepatitis. J Hepatol 1995; 22: 696-699.
Bonekamp D, Bonekamp S, Ou HY, et al. Assessing liver fibrosis: comparison of arterial enhancement fraction and diffusion-weighted imaging. J Magn Reson Imaging 2014; 40: 1137-1146.
Harada TL, Saito K, Araki Y, et al. Prediction of high-stage liver fibrosis using ADC value on diffusion-weighted imaging and quantitative enhancement ratio at the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI at 1.5 T. Acta Radiol 2018; 59: 509-516.
Bülow R, Mensel B, Meffert P, et al. Diffusion-weighted magnetic resonance imaging for staging liver fibrosis is less reliable in the presence of fat and iron. Eur Radiol 2013; 23: 1281-1287.
Taouli B, Chouli M, Martin AJ, et al. Chronic hepatitis: role of diffusion-weighted imaging and diffusion tensor imaging for the diagnosis of liver fibrosis and inflammation. J Magn Reson Imaging 2008; 28: 89-95.
Tosun M, Inan N, Sarisoy HT, et al. Diagnostic performance of conventional diffusion weighted imaging and diffusion tensor imaging for the liver fibrosis and inflammation. Eur J Radiol 2013; 82: 203-207.
Cheung JS, Fan SJ, Gao DS, et al. Diffusion tensor imaging of liver fibrosis in an experimental model. J Magn Reson Imaging 2010; 32: 1141-1148.
Huang M, Lu X, Wang X, Shu J. Diffusion tensor imaging quantifying the severity of chronic hepatitis in rats. BMC Med Imaging 2020; 20: 74. doi: 10.1186/s12880-020-00466-3.
Lee Y, Kim H. Assessment of diffusion tensor MR imaging (DTI) in liver fibrosis with minimal confounding effect of hepatic steatosis. Magn Reson Med 2015; 73: 1602-1608.
Soylemez UPO, Mut DT, Alkim CA, et al. The efficiency of fractional anisotropy, apparent diffusion coefficient, and contrast enhancement index in liver fibrosis staging. Sisli Etfal Hastan Tip Bul 2022; 56: 113-118.
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