Effects of microperfusion in hepatic diffusion weighted imaging

Hildebrand Dijkstra*, Paul Baron, Peter Kappert, Matthijs Oudkerk, Paul E. Sijens

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

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    Abstract

    Clinical hepatic diffusion weighted imaging (DWI) generally relies on mono-exponential diffusion. The aim was to demonstrate that mono-exponential diffusion in the liver is contaminated by microperfusion and that the bi-exponential model is required.

    Nineteen fasting healthy volunteers were examined with DWI (seven b-values) using fat suppression and respiratory triggering (1.5 T). Five different regions in the liver were analysed regarding the mono-exponentially fitted apparent diffusion coefficient (ADC), and the bi-exponential model: molecular diffusion (D (slow) ) microperfusion (D (fast) ) and the respective fractions (f (slow/fast)). Data were compared using ANOVA and Kruskal-Wallis tests. Simulations were performed by repeating our data analyses, using just the DWI series acquired with b-values approximating those of previous studies.

    Median mono-exponentially fitted ADCs varied significantly (P <0.001) between 1.107 and 1.423 x 10(-3) mm(2)/s for the five regions. Bi-exponential fitted D-slow varied between 0.923 and 1.062 x 10(-3) mm(2)/s without significant differences (P = 0.140). D (fast) varied significantly, between 17.8 and 46.8 x 10(-3) mm(2)/s (P <0.001). F-tests showed that the diffusion data fitted the bi-exponential model significantly better than the mono-exponential model (F > 21.4, P <0.010). These results were confirmed by the simulations.

    ADCs of normal liver tissue are significantly dependent on the measurement location because of substantial microperfusion contamination; therefore the bi-exponential model should be used.

    Diffusion weighted MR imaging helps clinicians to differentiate tumours by diffusion properties

    Fast moving water molecules experience microperfusion, slow molecules diffusion

    Hepatic diffusion should be measured by bi-exponential models to avoid microperfusion contamination

    Mono-exponential models are contaminated with microperfusion, resulting in apparent regional diffusion differences

    Bi-exponential models are necessary to measure diffusion and microperfusion in the liver.

    Original languageEnglish
    Pages (from-to)891-899
    Number of pages9
    JournalEuropean Radiology
    Volume22
    Issue number4
    DOIs
    Publication statusPublished - Apr-2012

    Keywords

    • Diffusion weighted imaging
    • IVIM
    • Liver parenchyma
    • Microperfusion
    • ADC variability
    • ECHO-PLANAR MR
    • INTRAVOXEL INCOHERENT MOTION
    • FOCAL LIVER-LESIONS
    • AGE-RELATED-CHANGES
    • ABDOMINAL ORGANS
    • COEFFICIENT MEASUREMENTS
    • PERFUSION
    • PARENCHYMA
    • ABDOMEN
    • METASTASES

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