磁共振成像质子密度脂肪分数和磁共振波谱测定的肝脏脂肪含量与非酒精性脂肪性肝病肝脏组织学的比较

A comparison of liver fat content as determined by magnetic resonance imaging-proton density fat fraction and MRS versus liver histology in non-alcoholic fatty liver disease.

作者信息

Idilman Ilkay S, Keskin Onur, Celik Azim, Savas Berna, Elhan Atilla Halil, Idilman Ramazan, Karcaaltincaba Musturay

机构信息

Hacettepe University, School of Medicine, Department of Radiology, Liver Imaging Team, Ankara, Turkey.

Department of Gastroenterology, Ankara University, Faculty of Medicine, Ankara, Turkey.

出版信息

Acta Radiol. 2016 Mar;57(3):271-8. doi: 10.1177/0284185115580488. Epub 2015 Apr 8.

DOI:10.1177/0284185115580488

PMID:25855666

Abstract

BACKGROUND

Many imaging methods have been defined for quantification of hepatic steatosis in non-alcoholic fatty liver disease (NAFLD). However, studies comparing the efficiency of magnetic resonance imaging-proton density fat fraction (MRI-PDFF), magnetic resonance spectroscopy (MRS), and liver histology for quantification of liver fat content are limited.

PURPOSE

To compare the efficiency of MRI-PDFF and MRS in the quantification of liver fat content in individuals with NAFLD.

MATERIAL AND METHODS

A total of 19 NAFLD patients underwent MRI-PDFF, MRS, and liver biopsy for quantification of liver fat content. The MR examinations were performed on a 1.5 HDx MRI system. The MRI protocol included T1-independent volumetric multi-echo gradient-echo imaging with T2* correction and spectral fat modeling and MRS with STEAM technique.

RESULTS

A close correlation was observed between liver MRI-PDFF- and histology- determined steatosis (r = 0.743, P < 0.001) and between liver MRS- and histology-determined steatosis (r = 0.712, P < 0.001), with no superiority between them (ƶ = 0.19, P = 0.849). For quantification of hepatic steatosis, a high correlation was observed between the two MRI methods (r = 0.986, P < 0.001). MRI-PDFF and MRS accurately differentiated moderate/severe steatosis from mild/no hepatic steatosis (P = 0.007 and 0.013, respectively), with no superiority between them (AUCMRI-PDFF = 0.881 ± 0.0856 versus AUCMRS = 0.857 ± 0.0924, P = 0.461).

CONCLUSION

Both MRI-PDFF and MRS can be used for accurate quantification of hepatic steatosis.

摘要

背景

已定义了多种成像方法用于量化非酒精性脂肪性肝病（NAFLD）中的肝脂肪变性。然而，比较磁共振成像-质子密度脂肪分数（MRI-PDFF）、磁共振波谱（MRS）和肝脏组织学在量化肝脏脂肪含量方面效率的研究有限。

目的

比较MRI-PDFF和MRS在量化NAFLD个体肝脏脂肪含量方面的效率。

材料与方法

共有19例NAFLD患者接受了MRI-PDFF、MRS和肝脏活检以量化肝脏脂肪含量。MR检查在1.5 HDx MRI系统上进行。MRI方案包括采用T2*校正的T1无关容积多回波梯度回波成像和频谱脂肪建模以及采用STEAM技术的MRS。

结果

肝脏MRI-PDFF与组织学确定的脂肪变性之间（r = 0.743，P < 0.001）以及肝脏MRS与组织学确定的脂肪变性之间（r = 0.712，P < 0.001）观察到密切相关性，它们之间无优越性（ƶ = 0.19，P = 0.849）。对于肝脂肪变性的量化，两种MRI方法之间观察到高度相关性（r = 0.986，P < 0.001）。MRI-PDFF和MRS能准确区分中度/重度脂肪变性与轻度/无肝脂肪变性（分别为P = 0.007和0.013），它们之间无优越性（AUCMRI-PDFF = 0.881 ± 0.0856 vs AUCMRS = 0.857 ± 0.0924，P = 0.461）。