Combination of MR Dynamic Contrast-Enhanced Imaging with T2-Corrected Intra-Voxel Incoherent Motion Imaging at 3.0T to Assess Liver Fibrosis

Benjamin Leporq¹, Frank Pilleul¹, Jerome Dumortier², Olivier Guillaud², Thibaud Lefort², Olivier Beuf¹

Liver fibrosis is an important cause of mortality and morbidity in patients with chronic liver diseases. While an early detection and a clinical follow-up of liver fibrosis are required for therapeutic strategies, the actual gold standard cannot be used in the clinical follow-up due to inherent risk, interobserver variability and sampling errors. Our objective was to evaluate the combination of IVIM with perfusion imaging using a MR-DCE technique for liver fibrosis assessment at 3.0 T in patients with chronic liver diseases. The link between perfusion-related diffusion given by IVIM and quantitative perfusion parameters given by MR-DCE imaging was investigated. Results indicated that the combination of IVIM and MR-DCE imaging do not bring additional information for fibrosis assessment in a large spectra of etiologies. Indeed, perfusion parameters given by MR-DCE imaging alone are relevant to evaluate fibrosis severity whereas fat overload constitute a confounding factor for fibrosis evaluation with IVIM when NAFLD and chronic hepatitis are mixed. Nevertheless, since IVIM can give information about both hemodynamic changes and molecular diffusion restriction induced by the deposition of extracellular matrix components associated to liver fibrosis, IVIM could be a useful injection-free method to distinguish between pure steatosis and NASH in patients with NAFLD, if combined with a suitable MR fat quantification method.