Purpose:To evaluate the use of apparent diffusion coefficient (ADC) measurements based on diffusion-weighted MRI (DWI) to assess stage of liver disease. Materials and Methods:A total of 31 patients who underwent both a liver biopsy and DWI and 132 patients who only underwent DWI were enrolled. Biopsy specimens were scored for fibrosis and necroinflammation according to the Knodell histology activity index (HAI). The 31 patients consisted of 21 patients with chronic hepatitis and 10 with cirrhosis (ChildPugh stage A in nine and stage B in one), and the 132 patients consisted of 56 patients with cirrhosis (Child-Pugh stage A in 41, stage B in 10, and stage C in five), 42 with chronic hepatitis, and 34 with normal liver function. The ADCs in the liver parenchyma were measured using DWI with relatively low b factors (b ϭ 0.01 and 128.01 seconds/mm 2 ) and were compared among the HAI scores and among patients with cirrhosis, chronic hepatitis, and normal liver function. Results:The ADCs decreased as the fibrosis score in the HAI increased, and the correlation was statistically significant (P Ͻ 0.0001). No relationship between the ADCs and the necroinflammation scores in the HAI was found. The ADCs decreased as the stage of liver disease progressed or as the Child-Pugh stage progressed, and these relationships were statistically significant (P Ͻ 0.0001).Conclusion: ADC measurements are potentially useful for the evaluation of fibrosis staging in the liver.

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Low-attenuation hemangiomas and those that changed from homogeneous high to isoattenuation are atypical and difficult to differentiate from other neoplasms. Most early parenchymal enhancement is caused by associated arterioportal shunts.

Two-phase dynamic incremental CT was superior to the other techniques and is a useful and easy procedure for routine follow-up of patients with chronic liver disease.