Assessment of Liver Fibrosis: Comparison of Magnetic Resonance Elastography (MRE) and Diffusion-weighted Imaging (DWI)

INTRODUCTION: Hepatic fibrosis is a wound-healing response to multiple types of chronic liver disease or injury. Cirrhosis, the end-stage of liver fibrosis, is a major cause of death due to its association with hepatocellular carcinoma and complicated portal hypertension. Accurate discrimination of advanced fibrosis and cirrhosis from mild fibrosis in patients with chronic liver disease is essential for diagnostic and therapeutic management. Liver biopsy is considered the gold standard for diagnosis of hepatic fibrosis; however, sampling errors, cost, and low acceptance by patients are inherent problems. Therefore, a more accurate, reproducible and well-tolerated technique is required for clinical practice. Recently, magnetic resonance elastography (MRE) [1,2,3] and diffusion-weighted imaging (DWI) [4] have been used as non-invasive imaging tools to evaluate liver fibrosis. The purpose of our study was to compare the discriminatory capabilities of MRE and DWI in detecting and staging hepatic fibrosis in patients with suspected chronic liver disease using histopathologic analysis as the reference standard.