Diffusion-weighted MRI and fibroscan vs. histopathology for assessment of liver fibrosis in chronic HCV patients: (Pilot study)

Introduction: HCV infection is responsible for liver fibrosis. Fibroscan and diffusion MRI have been proposed for non-invasive diagnosis and staging of hepatic fibrosis. Aim of the work: To assess the accuracy of diffusion MRI and/or fibroscan in the diagnosis of liver fibrosis as compared to histopathology. Patients and methods pre-treatment laboratory work up, fibroscan, diffusion MRI of the liver and liver biopsy were done for 52 chronic HCV patients for assessment of liver fibrosis. Results: There was a significant difference between ADC values of F0 vs. F1, F3 and F4 (P = 0.008, 0.033 and 0.015) respectively, however no significant differences were seen in the ADC values between the other different fibrosis stages. As regard the liver stiffness values, there was a significant difference between F1 and F3 (P = 0.001), F1 and F4 (P = 0.024) and between F2 and F3 (P = 0.014).There was no significant difference in the ADC values between (F0, F1, F2) on one hand and (F3, F4) on the other hand (P = 0.387), while there was a highly significant difference in the liver stiffness values between both groups (p < 0.001). Conclusions: Diffusion MRI can distinguish non-fibrotic liver (F0) from advanced fibrosis (F3 and F4) but cannot be used to distinguish between the intermediate stages of fibrosis-fibroscan can differentiate between (F0, F1, F2) and (F3, F4)