Diffusion-weighted magnetic resonance imaging for the assessment of liver fibrosis in chronic viral hepatitis.

BackgroundAccurate noninvasive methods for the assessment of liver fibrosis are urgently needed. This prospective study evaluated the diagnostic accuracy of diffusion-weighted magnetic resonance imaging (DWI) for the staging of liver fibrosis and proposed a diagnostic algorithm using DWI to identify cirrhosis in patients with chronic viral hepatitis.MethodsOne hundred twenty-one treatment-naïve patients with chronic hepatitis B or C were evaluated with DWI followed by liver biopsy on the same day. Breath-hold single-shot echo-planar DWI was performed to measure the apparent diffusion coefficient (ADC) of the liver and spleen. Normalized liver ADC was calculated as the ratio of liver ADC to spleen ADC.ResultsThere was an inverse correlation between fibrosis stage and normalized liver ADC (p3.25 yielded an 80% PPV for cirrhosis, and a 100% NPV to exclude cirrhosis in patients with Fibrosis-4 between 1.45 and 3.25. Only 15.7% of patients would require a liver biopsy. This sequential strategy can reduce DWI examinations by 53.7%.ConclusionNormalized liver ADC measurement on DWI is an accurate and noninvasive tool for the diagnosis of cirrhosis in patients with chronic viral hepatitis

Siriraj Thyroid Imaging Reporting and Data System and Its Efficacy

Objective: To standardize a modified practical thyroid imaging reporting and data system (Siriraj-TIRADS). Methods: 196 thyroid nodules underwent ultrasound and FNAB and were retrospectively pathologically proven. Data design was divided into 2 groups of benign and malignant. Sensitivity and specificity of cancer prediction were calculated for the comparison of Siriraj-TIRAD and TIRAD. Interobserver agreement was calculated by kappa statistics. Results: Sensitivity and specificity of Siriraj’s TIRADS on cancer prediction were 95% and 64.8%, respectively, and sensitivity and specificity of TIRADS were 45% and 92%, respectively. Conclusion: The Siriraj- TIRADS classification is easy, practical and has better sensitivity than TIRADS for the diagnosis of thyroid carcinoma. TIRADS is good for the screening management strategy but Siriraj-TIRADS has benefit to cancer management strategy