Background: Egypt is the highest affected country with Chronic hepatitis C with a prevalence of 22%. . Seroprevalence of HCV is 0.2% in children < 11 years and 0.4% in children ≥11 years of age.

Aim : To evaluate the use of 1H MRS and DW-MRI in early detection of liver fibrosis by measuring some metabolic components (Glx/lipid, PME/lipid and Glyu/lipid ratios) and ADC in liver tissues in relation to histopathological changes.

Methods: A cross-sectional study was conducted from 2012-2014, included thirty children (25 ♂ & 5♀ ) with asymptomatic chronic hepatitis C infection matched to twenty healthy children as controls . Anti HCV antibodies, HCV RNA PCR, liver function tests , abdominal ultrasonography, percutaneous liver biopsy and IH MRS (Glx/lipid, PME/lipid, Glyu/lipid ratios) and DW-MRI were done.

Results: METAVIR grades showed 29 cases (96.6%) had activity while 17 cases (56.7 %) had fibrosis and +ve TGF-β1 in liver tissues in 19 cases (63.3%). Significant positive correlations between the results of 1H MRS and liver biopsy (METAVIR Grades, Stages and TGF-β1). Multivariant regression analysis showed that DW-MRI (reflected by ADC) was the good predictor for activity and Glyu/lipid ratio of MRS was the good predictor of fibrosis.
Conclusion:Early diagnosis of asymptomatic chronic hepatitis C is essential to prevent or delay liver fibrosis. TGF-β1 in liver tissue may be considered a useful better tool in the assessment of hepatic fibrosis. 1H MRS may be a non-invasive helpful diagnostic tool in assessing asymptomatic chronic hepatitis C children