الفهرس 
Anatomy Of The LiverOnly 14 pages are availabe for public view
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Abstract
Objectives:
To investigate the value of liver ADC normalization using spleen as a reference organ in liver fibrosis assessment, in comparison with transient elastography (Fibroscan).
Materials and methods
: A total of 60 participants were included,30 HCV positive patients and 30 in the control group. We calculated mean Spleen apparent diffusion coefficient (ADC), liver mean ADC and normalized liver ADC (defined as the ratio of Liver ADC to spleen ADC) which were compared between cirrhotic patients and the control group. Data was analyzed and ROC was used to evaluate the performance of nADC.
Results:
No significant difference between spleen ADC values of patient group and control group or in-betweens different fibrosis stages. A significant negative correlation between liver ADC value and stages of fibrosis (r = -0.900; p = 0.0374)).We also found that the mean liver ADC and nADC value in patients with hepatic fibrosis was significantly lower than that of volunteers (1.53 × 10−3 mm2/s vs. 1.65 × 10−3 mm2/s, p = 0.001 &1.). Liver ADC only could distinguish F0 from F4. After analysis with ROC, there was a statistically significant difference between area under the receiver operating characteristic curve (AUC) of normalized liver ADC and ADC for all groups except for F4 stage. nADC AUC was 0.878 for detection of stage ≥ F2 with sensitivity and specificity of 87% & 80% respectively while ADC AUC was 0.548 with sensitivity and specificity of 62 % & 72% respectively(p=0.021), ≥ F3 AUC of nADC was0.891 with sensitivity and specificity of 88.7 % & 80% respectively while ADC AUC is 0.603 with sensitivity and specificity of 72% & 72% respectively(p=0.03), and F4 stage nADC AUC was0.879 for with sensitivity and specificity of 90% & 80% respectively ,while ADC AUC was 0.648 with sensitivity and specificity of 80 % & 72% respectively(p=0.054)
Conclusion:
normalized liver ADC using the spleen as reference organs increases the diagnostic performance of MRI in evaluation of liver fibrosis in comparison to ADC alone.