A CROSS-SECTIONAL STUDY IN EVALUATION OF SPLEEN USING DIFFUSION WEIGHTED IMAGING IN PATIENTS WITH CIRRHOSIS AND PH AT A TERTIARY CARE CENTRE, CHENGALPATTU DISTRICT, TAMILNADU

Abstract

Portal hypertension (PH) is a major complication of cirrhosis and is associated with considerable morbidity and mortality. Non-invasive imaging biomarkers for assessing disease severity are increasingly being investigated. Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) measurements of the spleen may provide valuable insights into portal hypertensive changes. This study aimed to evaluate splenic apparent diffusion coefficient values using diffusion-weighted magnetic resonance imaging in patients with cirrhosis and portal hypertension and to assess their association with disease severity. This cross-sectional study included 70 participants, comprising 50 patients with cirrhosis and portal hypertension and 20 healthy controls. MRI examinations were performed using a 1.5-T system with Diffusion-weighted imaging acquired at b-values of 0, 500, and 1000 s/mm². Splenic apparent diffusion coefficient values were measured from apparent diffusion coefficient maps and correlated with clinical, laboratory, endoscopic, and radiological indicators of portal hypertension. Statistical analyses were performed using SPSS version 17. Splenic apparent diffusion coefficient values were significantly higher in cirrhotic patients than in controls. Elevated splenic apparent diffusion coefficient values were significantly associated with worsening esophageal varices, variceal bleeding, hypersplenism, increasing ascites severity, and advancing Child–Pugh class. Significant positive correlations were observed between splenic apparent diffusion coefficient values, portal vein diameter, and spleen size. Receiver Operating Characteristic (ROC) analysis demonstrated good diagnostic performance of the splenic apparent diffusion coefficient for predicting variceal bleeding. Splenic apparent diffusion coefficient derived from diffusion-weighted MRI is a promising non-invasive imaging biomarker for assessing portal hypertension severity.