MRI-based estimation of liver function by intravoxel incoherent motion diffusion-weighted imaging

Abstract Purpose To explore the usefulness of intravoxel incoherent motion (IVIM) to evaluate the hepatic functional reserve as expressed by the model for Child–Pugh class. Materials and methods IVIM diffusion-weighted imaging (DWI) using 10 different b values were performed on a Philips 3.0 T MR scanner in 70 patients with liver cirrhosis and 60 healthy volunteers as the control group. Patients with liver cirrhosis were subdivided into three groups: Child–Pugh class A: 29 cases; Child–Pugh class B: 19 cases; Child–Pugh class C: 22 cases. Pure molecular diffusion (D), pseudo-diffusion (D*), perfusion fraction ( f ) and apparent diffusion coefficient (ADC) values were calculated, and used to determine liver function, as indicated by the Child–Pugh class. Results The ICC values of D, D*, f and ADC between two radiologists were 0.997, 0.986, 0.985 and 0.995, respectively. D*, f and ADC values of liver cirrhosis group were significantly lower than control group (P  f and ADC values significantly decreased with increasing Child–Pugh scores (p  f values (r = − 0.423, r = − 0.620, respectively). The areas under the curve (AUCs) of D* and f for evaluating liver function were 0.67–0.90 and 0.78–0.89, respectively. Conclusion IVIM DWI may be a useful image-based method for assessing liver function.