Value of diffusion-weighted imaging in diagnosis and therapy response assessment of hepatic fungal infection in patients with acute leukemia.

Objective: To investigate the role of diffusion-weighted imaging (DWI) for diagnosis and posttreatment assessment of hepatic fungal infection in patients with acute leukemia.

Methods: Patients with acute leukemia and highly suspected hepatic fungal infection were collected in the study. All the patients underwent MRI examination, including initial and follow-up DWI. The apparent diffusion coefficient (ADC) values of the lesions and the normal liver parenchyma were compared using Student's t-test. The ADC values of the hepatic fungal lesions of pretreatment and posttreatment were compared using paired t-test.

Results: A total of 13 patients with hepatic fungal infections have enrolled this study. Hepatic lesions were rounded or oval shaped, measured from 0.3 to 3 cm in diameter. The lesions showed significantly hyperintense signal on DWI and markedly hypointense signal on the ADC map, reflecting a marked restricted diffusion. The mean ADC values of the lesions were significantly lower than those of normal liver parenchyma (1.08 ± 0.34 × 10 vs. 1.98 ± 0.12 × 10  mm /s, p < 0.001). After treatment, the mean ADC values of the lesions were significantly increased when comparing with those of pretreatment (1.39 ± 0.29 × 10 vs. 1.06 ± 0.10 × 10 mm /s, p = .016).

Conclusion: DWI can provide diffusion information of hepatic fungal infection in patients with acute leukemia, which could be taken as a valuable tool for diagnosis and therapy response assessment of these patients.