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Intravoxel incoherent motion diffusion-weighted imaging for evaluating the pancreatic perfusion in cirrhotic patients

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Abstract

Purpose

To assess the characteristics of pancreatic perfusion in normal pancreas versus cirrhotic patients using intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI).

Methods

A total of 67 cirrhotic patients and 33 healthy subjects underwent IVIM on a 3.0 T MRI scanner. Diffusion coefficient (ADCslow), pseudo-diffusion coefficient (ADCfast), and perfusion fraction (f) were calculated based on the bi-exponential model. The pancreatic IVIM-derived parameters were then compared. In the cirrhotic group, the relationship was analyzed between IVIM-derived pancreatic parameters and different classes of hepatic function as determined by the Child-Pugh classification. Also, the pancreatic IVIM-derived parameters were compared among different classes of cirrhosis as determined by the Child-Pugh classification.

Results

The f value of the pancreas in cirrhotic patients was significantly lower than that in normal subjects (p = 0.01). In the cirrhotic group, the f value of the pancreas decreased with the increase of the Child-Pugh classification (R = − 0.49, p = 0.00). The f value of the pancreas was significantly higher in Child-Pugh class A patients than in class B and C patients (p = 0.02, 0.00, respectively), whereas there was no significant difference between class B and C patients (p = 0.16).

Conclusion

The IVIM-derived perfusion-related parameter (f value) could be helpful for the evaluation of pancreatic perfusion in liver cirrhosis. Our data also suggest that the blood perfusion decrease in the pancreas is present in liver cirrhosis, and the pancreatic perfusion tends to decrease with the increasing severity of hepatic function.

Trial registration

Trial registration number is 2021-ky-68 and date of registration for prospectively registered trials is February 23, 2022.

Graphical abstract

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Abbreviations

CE-US:

Dynamic contrast-enhanced ultrasound

CT:

Computed tomography

DWI:

Diffusion-weighted imaging

MRI:

Magnetic resonance imaging

ADC:

Apparent diffusion coefficient

IVIM:

Intravoxel incoherent motion

f :

Perfusion fraction

ADCfast :

Pseudo-diffusion coefficient

ADCslow :

Diffusion coefficient

TR:

Repetition time

TE:

Echo time

FOV:

Field of view

NEX:

Number of excitation

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Acknowledgements

The authors would like to express their deepest gratitude to the technicians who performed IVIM-MRI scans on all subjects in the department of radiology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China.

Funding

This work was supported by the National Natural Science Foundation of China (Grant No. 82172092), Key Project of Application Development Plan of Chongqing (Grant No. cstc2019jscx-dxwt BX0004) and the Chengdu University of Traditional Chinese Medicine “**nglin Scholars” Discipline Talents Research Promotion Plan (Grant No. YYZX2021059).

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Authors and Affiliations

  1. Department of Radiology, Chongqing Hospital of Traditional Chinese Medicine, No.6, Panxi 7th Road, Jiangbei District, Chongqing, 400021, People’s Republic of China

    Ran Hu, Guo-Fei Zeng, Yu Fang & Hua Yang

  2. GE Healthcare, MR Research China, Bei**g, People’s Republic of China

    Lisha Nie & Hui-Lou Liang

  3. Department of Ultrasound, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong Distinct, Chongqing, 400010, People’s Republic of China

    Zhi-Gang Wang

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  1. Ran Hu
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Correspondence to Zhi-Gang Wang or Hua Yang.

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Hu, R., Zeng, GF., Fang, Y. et al. Intravoxel incoherent motion diffusion-weighted imaging for evaluating the pancreatic perfusion in cirrhotic patients. Abdom Radiol 49, 492–500 (2024). https://doi.org/10.1007/s00261-023-04063-0

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  • DOI: https://doi.org/10.1007/s00261-023-04063-0

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