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• Clinical Article •
Influence of liver iron overload and steatosis on ADC value in evaluating liver fibrosis in patients with chronic hepatitis B
PAN Zhongxian  LI Zhujing  LIAO Jiong  HAO Liantao  MENG Fanqi  HU Yuanming  HUANG Rong  YANG Xiaoyan  WEN Wucheng  CHEN Yueyao 

Cite this article as: Pan ZX, Li ZJ, Liao J, et al. Influence of liver iron overload and steatosis on ADC value in evaluating liver fibrosis in patients with chronic hepatitis B[J]. Chin J Magn Reson Imaging, 2021, 12(7): 18-23. DOI:10.12015/issn.1674-8034.2021.07.004.


[Abstract] Objective To investigate the effect of hepatic iron overload and steatosis on ADC value in evaluating liver fibrosis in patients with chronic hepatitis B (CHB). Materials andMethods Seventy-three patients with CHB were included in this study. R2* and proton density fat fraction (PDFF) were measured by multi-echo Dixon for the diagnosis of hepatic iron overload and steatosis, respectively. Patients were grouped according to the presence or absence of liver iron overload and steatosis. The differences of ADC values between the groups were estimated. Liver fibrosis grading was performed according to an alternative standard recommended by WHO. The correlation between ADC​​ values and R2*, PDFF, fibrosis grade, age, gender was analysed. Multiple linear regression analysis was performed. The correlation between ADC values and fibrosis grade was analysed after excluding patients with liver iron overload or/and steatosis.Results The ADC values of the liver iron overload group and the steatosis group were significantly reduced (P＜0.05). R2*, PDFF, and liver fibrosis grade were all negatively correlated with ADC values (r=-0.457, -0.298, -0.385, respectively, P＜0.05). And they were affecting factors of ADC values (standardized regression coefficient=-0.307, -0.382, -0.412; t=-2.666, -3.331, -3.510; respectively, P＜0.05). After excluding patients with liver iron overload or/and steatosis, the correlation between ADC value and liver fibrosis grade was significantly improved, and the correlation coefficients were -0.573, -0.456, and -0.688, respectively, P＜0.05.Conclusions Hepatic iron overload and steatosis could reduce the ADC value and additionally affect the correlation between ADC values and liver fibrosis grade. When using ADC value to evaluate liver fibrosis in patients with CHB, the influence of liver iron overload and steatosis should be noticed.
[Keywords] chronic hepatitis B；iron overload；fatty liver；liver fibrosis；diffusion weighted imaging；apparent diffusion coefficient

PAN Zhongxian1   LI Zhujing1   LIAO Jiong1   HAO Liantao1   MENG Fanqi1   HU Yuanming1   HUANG Rong2   YANG Xiaoyan1   WEN Wucheng1   CHEN Yueyao1*  

1 Department of Radiology, Shenzhen Traditional Chinese Medicine Hospital, the Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen 518033, China

2 Department of Radiology, Peking University Shenzhen Hospital, Shenzhen 518036, China

Chen YY, E-mail: drchenyueyao@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS This research was supported by the National Natural Science Foundation of China (No. 81903960).
Received  2021-01-12
Accepted  2021-04-01
DOI: 10.12015/issn.1674-8034.2021.07.004
Cite this article as: Pan ZX, Li ZJ, Liao J, et al. Influence of liver iron overload and steatosis on ADC value in evaluating liver fibrosis in patients with chronic hepatitis B[J]. Chin J Magn Reson Imaging, 2021, 12(7): 18-23. DOI:10.12015/issn.1674-8034.2021.07.004.

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