Hepatosplenic candidiasis in patient with acute leukemia

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 × 10-3 vs. 1.98 ± 0.12 × 10-3  mm2 /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 × 10-3 vs. 1.06 ± 0.10 × 10-3 mm2 /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.