T1 加权双回波 MRI 用于儿科非酒精性脂肪性肝病的脂肪定量。
T1-weighted dual-echo MRI for fat quantification in pediatric nonalcoholic fatty liver disease.
机构信息
Department of Pediatrics, Sapienza University of Rome, Viale Regina Elena 324, 00161-Rome, Italy.
出版信息
World J Gastroenterol. 2011 Jul 7;17(25):3012-9. doi: 10.3748/wjg.v17.i25.3012.
AIM
To determine in obese children with nonalcoholic fatty liver disease (NAFLD) the accuracy of magnetic resonance imaging (MRI) in assessing liver fat concentration.
METHODS
A case-control study was performed. Cases were 25 obese children with biopsy-proven NAFLD. Controls were 25 obese children matched for age and gender, without NAFLD at ultrasonography and with normal levels of aminotransferases and insulin. Hepatic fat fraction (HFF) by MRI was obtained using a modification of the Dixon method.
RESULTS
HFF ranged from 2% to 44% [mean, 19.0% (95% CI, 15.1-27.4)] in children with NAFLD, while in the controls this value ranged from 0.08% to 4.69% [2.0% (1.3-2.5), P < 0.0001]. HFF was highly correlated with histological steatosis (r = 0.883, P < 0.0001) in the NAFLD children. According to the histological grade of steatosis, the mean HFF was 8.7% (95% CI, 6.0-11.6) for mild, 21.6% (15.3-27.0) for moderate, and 39.7% (34.4-45.0) for severe fatty liver infiltration. With a cutoff of 4.85%, HFF had a sensitivity of 95.8% for the diagnosis of histological steatosis ≥ 5%. All control children had HFF lower than 4.85%; thus, the specificity was 100%. After 12 mo, children with weight loss displayed a significant decrease in HFF.
CONCLUSION
MRI is an accurate methodology for liver fat quantification in pediatric NAFLD.
目的
在非酒精性脂肪性肝病（NAFLD）的肥胖儿童中，评估磁共振成像（MRI）评估肝脂肪浓度的准确性。
方法
进行了病例对照研究。病例为 25 名经肝活检证实为 NAFLD 的肥胖儿童。对照组为 25 名年龄和性别匹配的肥胖儿童，超声检查无 NAFLD，肝转氨酶和胰岛素水平正常。采用 Dixon 法改良法获得肝脂肪分数（HFF）。
结果
NAFLD 患儿的 HFF 范围为 2%至 44%[平均值 19.0%（95%可信区间，15.1-27.4）]，而对照组为 0.08%至 4.69%[2.0%（1.3-2.5），P<0.0001]。在 NAFLD 患儿中，HFF 与组织学脂肪变性高度相关（r=0.883，P<0.0001）。根据脂肪变性的组织学分级，轻度脂肪变性的平均 HFF 为 8.7%（95%可信区间，6.0-11.6），中度为 21.6%（15.3-27.0），重度为 39.7%（34.4-45.0）。当截断值为 4.85%时，HFF 对组织学脂肪变性≥5%的诊断具有 95.8%的敏感性。所有对照组儿童的 HFF 均低于 4.85%；因此，特异性为 100%。减肥 12 个月后，儿童的 HFF 显著下降。
结论
MRI 是评估儿科 NAFLD 肝脂肪定量的准确方法。
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