Diagnostic Utility of Apparent Diffusion Coefficient Values of Spleen and Liver in Assessment of Severity of Portal Hypertension and Liver Cirrhosis

BACKGROUND: Portal hypertension (PH) is a significant effect of chronic liver disease (CLD), resulting in variceal haemorrhage, ascites and hypersplenism. Apparent diffusion coefficient (ADC) and diffusion-weighted imaging (DWI) values serve as potential non-invasive indicators for evaluating the PH and liver fibrosis. AIMS: This study evaluated the impact of portal hypertension on the ADC values of the liver and spleen and related PH severity with the Child-Pugh score. MATERIALS AND METHODS: A cross-sectional study was performed with individuals exhibiting clinical and radiological indications of CLD and PH and also with healthy controls. Magnetic resonance imaging was employed to assess spleen and liver ADC values, which were linked with clinical severity of diseases. RESULTS: Liver ADC levels were substantially reduced among patients with cirrhosis when compared with controls, suggesting the existence of fibrosis. Conversely, spleen ADC values were elevated in affected patients, signifying splanchnic congestion. A particular spleen ADC level showed elevated sensitivity and specificity for detecting severe illness. Liver ADC reduced and spleen ADC enhanced with worsening Child-Pugh classification. An increased spleen ADC correlated with variceal hypersplenism and haemorrhage. CONCLUSION: DWI-derived ADC values constitute a non-invasive, reliable method for assessing liver fibrosis and the severity of PH, hence validating their application in clinical evaluation and early management for patients with CLD.