Does steatosis affect the performance of diffusion-weighted MRI values for fibrosis evaluation in patients with chronic hepatitis C genotype 4?

Besheer, Tarek; Razek, Ahmed Abdel Khalek Abdel; Bendary, Mahmoud El; Maksoud, Mohamed Abd El; Elalfy, Hatem; Zalata, Khaled; Elkashef, Wagdi; Zaghloul, Hosam; El‐Gilany, Abdel‐Hady

doi:10.5152/tjg.2017.16640

Cited by 22 publications

(19 citation statements)

References 26 publications

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“…Besheer T (21) demonstrated that hepatic steatosis should always be considered when assessing hepatic brosis, and their study revealed that detected hepatic steatosis would underestimate the ADC value in patients with chronic hepatitis C. Accordingly, our study considered steatosis. However, our study results did not show a relationship between steatosis and either the rADC or FA value, which did not agree with the ndings of some previous research (21,(24)(25)(26). Other studies (15,27) demonstrated no signi cant relationship between the ADC value and steatosis, which was similar to our results.…”

Section: Discussioncontrasting

confidence: 94%

“…Because clinical therapy depends on the brotic stage and in ammatory grade, prior studies mainly used DTI for liver brosis and in ammation detection (10,11). However, some scholars emphasized that the ADC (21)(22)(23)(24) and FA value (12) in the liver need to be carefully interpreted in the presence of hepatic steatosis. Besheer T (21) demonstrated that hepatic steatosis should always be considered when assessing hepatic brosis, and their study revealed that detected hepatic steatosis would underestimate the ADC value in patients with chronic hepatitis C. Accordingly, our study considered steatosis.…”

Section: Discussionmentioning

confidence: 99%

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Diffusion Tensor Imaging Quantifying the Severity of Chronic Hepatitis in Rats

Huang

Shu³

2020

Preprint

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Abstract Background: Diffusion tensor imaging (DTI) is mainly used for detecting white matter fiber in the brain. DTI was applied to assess fiber in liver disorders in previous studies. However, the data obtained have been insufficient in determining if DTI can be used to exactly stage chronic hepatitis. This study assessed the value of DTI for staging of liver fibrosis (F), necroinflammatory activity (A) and steatosis (S) with chronic hepatitis in rats. Methods: Seventy male Sprague-Dawley rats were divided into a control group(n=10) and an experimental group(n=60). The rat models of chronic hepatitis were established by abdominal subcutaneous injections of 40% CCl4. All of the rats underwent 3.0T MRI. Regions of interest (ROIs) were subjected to DTI to estimate the MR parameters (rADC value and FA value). Histopathology was used as the reference standard. Multiple linear regression was used to analyze the associations between the MR parameters and pathology. The differences in the MR parameters among the pathological stages were evaluated by MANOVA or ANOVA. The LSD test was used to test for differences between each pair of groups. ROC analysis was also performed. Results: The count of each pathology was as follows: F0(n=15), F1(n=11), F2(n=6), F3(n=9), F4(n=6); A0(n=8), A1(n=16), A2(n=16), A3(n=7); S0(n=10), S1(n=7), S2(n=3), S3(n=11), S4(n=16). The rADC value had a negative correlation with liver fibrosis (r=-0.392, P=0.008) and inflammation (r=-0.359, P=0.015). The FA value had a positive correlation with fibrosis (r=0.409, P=0.005). Significant differences were found in the FA values between F4 and F0~F3 (P=0.03), while no significant differences among F0~F3 were found (P> 0.05). The AUC of the FA value differentiating F4 from F0~F3 was 0.909 (p<0.001) with an 83.3% sensitivity and an 85.4% specificity when the FA value was at the cut-off of 588.089 (×10-6mm2/s).Conclusion: The FA value for DTI can distinguish early cirrhosis from normal, mild and moderate liver fibrosis, but the rADC value lacked the ability to differentiate among the fibrotic grades. Both the FA and rADC values were unable to discriminate the stages of necroinflammatory activity and steatosis.

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Section: Discussioncontrasting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Diffusion Tensor Imaging Quantifying the Severity of Chronic Hepatitis in Rats

Huang

Shu³

2020

Preprint

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“…Because the clinical therapy depends on the fibrotic stage and inflammatory grade, in prior studies there were mainly about DTI for liver fibrosis and inflammation (8,9). But some scholars emphasized that ADC (17)(18)(19)(20) and FA value (10) in the liver need to be carefully interpreted in the presence of hepatic steatosis. Besheer T (17) demonstrated that hepatic steatosis should always be considered when assessing hepatic fibrosis and their study found that detected hepatic steatosis would underestimate ADC value in patients with chronic hepatitis C. Accordingly, our study took steatosis into consideration.…”

Section: Discussionmentioning

confidence: 99%

“…But some scholars emphasized that ADC (17)(18)(19)(20) and FA value (10) in the liver need to be carefully interpreted in the presence of hepatic steatosis. Besheer T (17) demonstrated that hepatic steatosis should always be considered when assessing hepatic fibrosis and their study found that detected hepatic steatosis would underestimate ADC value in patients with chronic hepatitis C. Accordingly, our study took steatosis into consideration. However, our study results did not find the relationship between steatosis and both rADC and FA value, which disaccorded with some of previous research (17,(20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

Quantitative Analysis of Diffusion Tensor Imaging in Chronic Hepatitis in Rats

Huang¹,

Lu²,

Wang³

et al. 2020

Preprint

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Abstract Background Diffusion tensor imaging (DTI) is mainly used for detecting white matter fiber in the brain. From this, DTI has been applied to assess fiber in liver disorders by prior studies. But non-sufficient data has been obtained if DTI could be used for exactly staging chronic hepatitis. This study is to assess the value of DTI for staging of liver fibrosis (F), necroinflammatory activity (A), and steatosis (S) of chronic hepatitis in rats. Methods Seventy male Sprague-Dawley rats were divided into control group(n = 10) and experimental group(n = 60). The rat models of chronic hepatitis were established by abdominal subcutaneous injections of 40% CCl4. All rats underwent 3.0T MRI. ROIs were placed on DTI to estimate MR parameters (rADC value and FA value). Histopathology was the reference standard. Multiple linear regression was used to analyze the association between MR parameters and pathology. The differences in rADC value and FA value among pathological stages were evaluated by MANOVA or ANOVA. LSD was used to test the differences between each two groups. ROC analysis was performed. Results The numbers of each pathology were as follows: F0(n = 15), F1(n = 11), F2(n = 6), F3(n = 9), F4(n = 6); A0(n = 8), A1(n = 16), A2(n = 16), A3(n = 7); S0(n = 10), S1(n = 7), S2(n = 3), S3(n = 11), S4(n = 16). The rADC value had a negative correlation with liver fibrosis (r=-0.392, P = 0.008) and inflammation (r=-0.359, P = 0.015). FA value had a positive correlation with fibrosis (r = 0.409, P = 0.005). Significant differences were found in FA value between F4 and F0 ~ F3 (P = 0.03), while no significant differences among F0 ~ F3 were found (P > 0.05). AUC of FA value in differentiating F4 from F0 ~ F3 was 0.909(p < 0.001) with 83.3% Sensitivity, 85.4% specificity when the FA value was at the cut-off of 588.089(× 10− 6mm2/s). Conclusion FA value for DTI can distinguish early cirrhosis from normal, mild and moderate liver fibrosis.

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“…Echoendoscopes are able to image both intramural structures and structures adjacent to the GI tract 11 EUS has the advantage of visualizing the biliary tree from within the duodenum without interference from abdominal gas or fat 12 . MRI has been used for different diagnostic modalities in the field of hepatgastroenterology whether medical or surgical [13][14][15] . MRCPs are performed with T2-weighted sequences that depict the biliary tract, as a highsignal intensity or bright structure without the use…”

Section: Introductionmentioning

confidence: 99%

The role of endoscopic ultrasound in patients with choledocholithiasis: A pilot study

Ahmed

Hatem

Gamal

et al. 2020

Medical Journal of Viral Hepatitis

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Background and study aim. Endoscopic ultrasound (EUS) is a diagnostic modality that continues to expand its clinical applications. The aim of this study is to evaluate the diagnostic role of EUS in common bile duct stones. Patients and methods: This study was carried on 29 patients with suspected CBD stones from them only 15 patients were diagnosed as Common Bile Duct stone(s). Endoscopic retrograde cholangiopancreatography (ERCP) is considered as gold standard for diagnosis of CBD stones and compare EUS findings with that of ERCP. Results: The diagnostic performance of EUS shows that the sensitivity, specificity, PPV, NPV and accuracy of 100%, 92.8%, 93.7%, 100% and 96.5% respectively. It can catch 15 true positive cases with only one false positive case and 13 of 14 true negative cases. EUS is considered as a minimally invasive method with low incidence of complications, allowing exact determination of the site and size of stones. So EUS aid in better planning for CBD stone removal. Conclusion: EUS is considered as a minimally invasive method with low incidence of complications, allowing exact determination of the site and size of stones with good diagnostic performance.

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Does steatosis affect the performance of diffusion-weighted MRI values for fibrosis evaluation in patients with chronic hepatitis C genotype 4?

Cited by 22 publications

References 26 publications

Diffusion Tensor Imaging Quantifying the Severity of Chronic Hepatitis in Rats

Diffusion Tensor Imaging Quantifying the Severity of Chronic Hepatitis in Rats

Quantitative Analysis of Diffusion Tensor Imaging in Chronic Hepatitis in Rats

The role of endoscopic ultrasound in patients with choledocholithiasis: A pilot study

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