A Combined Use of Intravoxel Incoherent Motion MRI Parameters Can Differentiate Early

This study investigated a combined use of intravoxel incoherent motion (IVIM) parameters, Dslow (D), PF (f), and Dfast (D*), for liver fibrosis evaluation. Sixteen healthy volunteers (F0) and 33 hepatitis-b patients (stage F1 = 15, stage F2–4 = 18) were included. With a 1.5 T MR scanner and respiration gating, IVIM diffusion-weighted imaging was acquired using a single-shot echo-planar imaging sequence with 10 b values of 10, 20, 40, 60, 80, 100, 150, 200, 400, and 800 s/mm2. Signal measurement was performed on right liver parenchyma. With a three-dimensional tool, Dslow, PF, and Dfast values were placed along the x axis, y axis, and z axis, and a plane was defined to separate healthy volunteers from patients. The three-dimensional tool demonstrated that healthy volunteers and all patients with liver fibrosis could be separated. Classification and regression tree showed that a combination of PF (PF < 12.55%), Dslow (Dslow < 1.152 × 10？3 mm2/s), and Dfast (Dfast < 13.36 × 10？3 mm2/s) could differentiate healthy subjects and all fibrotic livers (F1–4) with an area under the curve of logistic regression (AUC) of 0.986. The AUC for differentiation of healthy livers versus F2–4 livers was 1. PF offered the best diagnostic value, followed by Dslow; however, all three parameters of PF, Dslow, and Dfast contributed to liver fibrosis detection