POSSIBILITIES OF DIFFUSION-WEIGHTED LIVER IMAGE ON MRI IN PREDICTING ABSTINENCE DISORDERS IN PATIENTS WITH ALCOHOLIC LIVER DISEASE

Abstract

Objective. To evaluate the possibilities of diffusion-weighted image of the liver with MRI in predicting abstinence disorders in patients with alcoholic liver disease.

Methods. We examined 125 patients with alcoholic liver disease (ALD). Among them, 58 (46%) are men and 67 (54%) are women. The average age of patients is 43.4±4.8 years. All patients (n=125) underwent magnetic resonance imaging (MRI) of the abdominal cavity with the addition of a diffusion-weighted image mode, ultrasound of the abdominal organs with clinical elastography – 94 (75%) patients. The reference method was liver biopsy in 89 (71%) patients.

Results. The patients were monitored for 12 months. Based on the obtained data, the main complex magnetic resonance criteria were developed, the liver diffusion coefficient was calculated, and the characteristics of the diffusion-weighted image were evaluated. Thus, it was found that quantitative indicators of DWI are important for confirming clinical forms of ALD (AUROC=0.904 (95% CI 0.870-0.910)). The results of a biochemical blood test were compared with the data of a qualitative assessment of DWI: in 92 (74%) patients with cytolysis and cholestasis syndromes, diffusion restriction was detected (r=0.801), in 33 (26%) unchanged indicators – diffusion restriction was not detected (r=0.811). During dynamic monitoring of patients, against the background of treatment, positive clinical and laboratory dynamics was observed in 68 (54%) patients, which was confirmed by an increase in quantitative indicators of liver DWI by 1.5 times (r=0.834)

Conclusions. 1. Restriction of liver diffusion during MRI in patients with ALD correlates with changes in blood chemistry (r=0.801). 2. using MRI of the liver in the DWI mode makes it possible to carry out timely correction of treatment in patients with ALD, which, with positive clinical and laboratory dynamics, is expressed in the absence of diffusion restriction (r=0.834). 3. liver DWI in MRI has a high diagnostic significance in predicting withdrawal disorders in patients with ALD (AUC=0.891 (95% CI 0.872-0.951)).