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Evaluation of the Effect of Patient Preparation Using Castor Oil on ADC Value of Focal Liver Lesion

Authors Mahmood KA, Rashid RJ, Fateh SM, Mohammed NA

Received 31 October 2020

Accepted for publication 22 January 2021

Published 16 February 2021 Volume 2021:14 Pages 469—474


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Kawa Abdulla Mahmood, Rezheen Jamal Rashid, Salah Mohammed Fateh, Naser Abdullah Mohammed

University of Sulaimani, College of Medicine, Department of Surgery-Diagnostic Imaging Unit, Sulaymaniyah, Kurdistan Region, Iraq

Correspondence: Kawa Abdulla Mahmood Tel +9647701545538

Purpose: To estimate the role of patient preparation using castor oil on the ADC value of focal liver lesion.
Patients and Methods: Retrospective case-control study over more than two years. Magnetic resonance imaging (MRI) scan, including diffusion-weighted imaging (DWI) of the upper abdomen performed for 87 cases and 71 controls in patients with focal hepatic hemangiomas. Cases were prepared using castor oil prior to the scan without identifiable unwanted effect, while controls did not receive any special preparation. Since liver hemangioma is a common lesion, it was selected and used as a sample. Apparent Diffusion Coefficient (ADC) values of focal liver lesion were calculated in cases and controls.
Results: The mean ADC value of liver hemangioma was lower in cases compared to controls; the mean ADC value was (2.21± 0.39x10ˉ3mm2/s) in cases and (2.51± 0.49x10ˉ3mm2/s) in controls. Left lobes were more affected by lesions; the mean ADC value of the left lobe lesions was (2.26± 0.37 x10ˉ3mm2/s) and (2.86± 0.43 x10ˉ3mm2/s) in cases and controls, respectively. The ADC value of lesions in the right lobe was (2.19± 0.39x10ˉ3mm2/s) in cases and (2.39± 0.45x10ˉ3mm2/s) in controls. There was a significant segmental ADC variation; lesions at segments II, III, IVb, and V demonstrated illusive ADC elevation in controls.
Conclusion: There is erroneous elevation of lobar and segmental ADC value of liver hemangiomas in non prepared patients. This Potential source of error (peristalsis, partial volume, and paramagnetic gas effect of gastrointestinal tract) on hepatic lesions’ ADC value can be avoided by proper preparation using castor oil prior to MRI scanning.

Keywords: liver hemangioma, apparent diffusion coefficient value, patient preparation, castor oil

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