A comparative study of gadoxetic acid enhanced T1-mapping and diffusion-weighted imaging in assessing liver fibrosis

doi:10.3877/cma.j.issn.1674-0785.2018.04.009

Abstract

Abstract:

Objective

To evaluate the diagnostic value of gadoxetic acid enhanced magnetic resonance T1-mapping in assessing liver fibrosis by comparing with diffusion weighted imaging (DWI).

Methods

Thirty rats were divided into a CCl₄-induced fibrosis group (n=24) and a control group (n=6). The rats in the fibrosis group were further randomly divided into four subgroups (n=6 each) and administered with 50% CCl₄ intraperitoneally for 2, 4, 6, and 8 weeks, respectively. Rats in the control group were administered with the same dose of olive oil. Gadoxetic acid enhanced T1-mapping and DWI were performed, and the hepatobiliary phase (HBP) T1 relaxation time, reduction rate (Δ%), and apparent diffusion coefficient (ADC) were calculated. Spearman correlation analysis was used to assess the correlation between T1 relaxation time, ADC, and fibrosis stage (F), and one-way ANOVA (Δ%-T1) or Kruskal-Wallis test (HBP-T1 and ADC) was used to compare MR parameters between different fibrosis stages. Receiver operating characteristic curve analysis was used to assess the diagnostic performance of T1 relaxation time and ADC in discriminating F≥3 and cirrhosis.

Results

A total of 6, 5, 7, 5, and 7 rats were diagnosed with F0 to F4, respectively. HBP-T1, Δ%-T1 relaxation time, and ADC differed significantly between fibrosis stages (χ²=25.21, P<0.001; F=19.37, P<0.001; χ²=18.50, P=0.001). HBP relaxation time was positively correlated with fibrosis stage (r=0.927, P<0.001), while Δ%-T1 relaxation time and ADC were negatively related to fibrosis stage (r=-0.892, P<0.001; r=-0.778, P<0.001). ROC analysis demonstrated the areas under the curves of HBP and Δ% T1 relaxation time were larger than that of ADC (0.949 vs 0.944 vs 0.842) for identifying mild and severe fibrosis, but there was no statistical difference (Z=0.343, 1.495; P=0.135, 0.732); however, for non-cirrhosis and cirrhosis (0.988 vs 0.957 vs 0.804), there was a significant difference (Z=2.202, P=0.028; Z=2.004, P=0.045).

Conclusion

Gadoxetic acid enhanced T1-mapping may have higher value than conventional DWI in assessing liver fibrosis.

Key words: Liver fibrosis, Gadoxetic acid, Relaxation time, Diffusion weighted imaging, Magnetic resonance imaging

Ruofan Sheng, Kaipu Jin, Heqing Wang, Li Yang, Yuan Ji, Mengsu Zeng. A comparative study of gadoxetic acid enhanced T1-mapping and diffusion-weighted imaging in assessing liver fibrosis[J]. Chinese Journal of Clinicians(Electronic Edition), 2018, 12(04): 232-237.

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References 19

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分级	动物数（只）	HBP-T1［ms，M（Q_R）］	Δ%-T1（±s）	ADC［×10^-3mm²/s，M（Q_R）］
F0级	6	51.70（43.60，56.25）	87.89±2.36	1.171（1.139，1.273）
F1级	5	103.6（99.50，110.9）	82.41±3.28	1.101（1.063，1.122）
F2级	7	148.0（137.0，191.2）	76.35±5.39	1.003（0.923，1.045）
F3级	5	186.0（139.8，210.7）	71.73±7.09	0.977（0.963，1.059）
F4级	7	244.3（200.2，298.7）	61.63±8.03	0.974（0.914，1.024）
统计值	?	χ²=25.21	F=19.37	χ²=18.50
P值	?	<0.001	<0.001	0.001

分级	动物数（只）	HBP-T1［ms，M（Q_R）］	Δ%-T1（±s）	ADC［×10^-3mm²/s，M（Q_R）］
F0级	6	51.70（43.60，56.25）	87.89±2.36	1.171（1.139，1.273）
F1级	5	103.6（99.50，110.9）	82.41±3.28	1.101（1.063，1.122）
F2级	7	148.0（137.0，191.2）	76.35±5.39	1.003（0.923，1.045）
F3级	5	186.0（139.8，210.7）	71.73±7.09	0.977（0.963，1.059）
F4级	7	244.3（200.2，298.7）	61.63±8.03	0.974（0.914，1.024）
统计值	?	χ²=25.21	F=19.37	χ²=18.50
P值	?	<0.001	<0.001	0.001

项目	AUC（95%CI）	界值	敏感度（%）	特异度（%）	阳性预测值（%）	阴性预测值（%）
HBP-T1（ms）	0.949（0.802~0.996）	≤152.3	88.89	91.67	94.1	84.6
Δ%-T1	0.944（0.795~0.995）	>71.93	88.89	91.67	94.1	84.6
ADC（×10^-3mm²/s）	0.842（0.651~0.953）	>1.02	86.67	83.33	86.7	83.3

项目	AUC（95%CI）	界值	敏感度（%）	特异度（%）	阳性预测值（%）	阴性预测值（%）
HBP-T1（ms）	0.949（0.802~0.996）	≤152.3	88.89	91.67	94.1	84.6
Δ%-T1	0.944（0.795~0.995）	>71.93	88.89	91.67	94.1	84.6
ADC（×10^-3mm²/s）	0.842（0.651~0.953）	>1.02	86.67	83.33	86.7	83.3

项目	AUC（95%CI）	界值	敏感度（%）	特异度（%）	阳性预测值（%）	阴性预测值（%）
HBP-T1（ms）	0.988（0.862~1.000）	≤194	95.65	100.00	100.0	87.5
Δ%-T1	0.957（0.812~0.998）	>69.86	82.61	100.00	100.0	63.6
ADC（×10^-3mm²/s）	0.804（0.606~0.930）	>1.02	70.00	85.71	93.3	50.0

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