Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 5031, Cincinnati, OH, 45229-3026, USA.
Department of Radiology, Allegheny General Hospital, Pittsburgh, PA, USA.
Abdom Radiol (NY). 2018 May;43(5):1168-1179. doi: 10.1007/s00261-017-1289-y.
Magnetic resonance imaging (MRI) techniques are increasingly used to quantify and monitor liver tissue characteristics including fat fraction, stiffness, and liver volume. The purpose of this study was to assess the inter-relationships between multiple quantitative liver metrics and patient-specific factors in a large pediatric cohort with known or suspected fatty liver disease.
In this IRB-approved, HIPAA-compliant study, we retrospectively reviewed patient data and quantitative liver MRI results in children with known/suspected fatty liver disease. Relationships between liver MRI tissue characteristics and patient variables [sex, age, body mass index (BMI), diabetic status (no diabetes mellitus, insulin resistance/"prediabetes" diagnosis, or confirmed diabetes mellitus), and serum alanine transaminase (ALT)] were assessed using linear mixed models.
294 quantitative liver MRI examinations were performed in 202 patients [128/202 (63.4%) boys], with a mean age of 13.4 ± 2.9 years. Based on linear mixed models, liver fat fraction was influenced by age (-0.71%/+1 year, p = 0.0002), liver volume (+0.006%/+1 mL, p < 0.0001), liver stiffness (-2.80%/+1 kPa, p = 0.0006), and serum ALT (+0.02%/+1 U/L, p = 0.0019). Liver stiffness was influenced by liver volume (+0.0003 kPa/+1 mL, p = 0.001), fat fraction (-0.02 kPa/+1% fat, p = 0.0006), and ALT (0.002 kPa/+1 U/L, p = 0.0002). Liver volume was influenced by sex (-262.1 mL for girls, p = 0.0003), age (+51.8 mL/+1 year, p = 0.0001), BMI (+49.1 mL/+1 kg/m, p < 0.0001), fat fraction (+30.5 mL/+1% fat, p < 0.0001), stiffness (+192.6 mL/+1 kPa, p = 0.001), and diabetic status (+518.94 mL for diabetics, p = 0.0009).
Liver volume, fat fraction, and stiffness are inter-related and associated with multiple patient-specific factors. These relationships warrant further study as MRI is increasingly used as a non-invasive biomarker for fatty liver disease diagnosis and monitoring.
磁共振成像（MRI）技术越来越多地用于定量和监测肝脏组织特征，包括脂肪分数、硬度和肝体积。本研究的目的是在一个已知或疑似脂肪性肝病的大型儿科队列中，评估多种定量肝指标与患者特定因素之间的相互关系。
本研究经机构审查委员会批准、符合 HIPAA 规定，我们回顾性分析了患有已知/疑似脂肪性肝病的儿童的患者数据和定量肝 MRI 结果。使用线性混合模型评估肝 MRI 组织特征与患者变量[性别、年龄、体重指数（BMI）、糖尿病状态（无糖尿病、胰岛素抵抗/“前驱糖尿病”诊断或确诊糖尿病）和血清丙氨酸转氨酶（ALT）]之间的关系。
在 202 名患者中进行了 294 次定量肝 MRI 检查[128/202（63.4%）名男孩]，平均年龄为 13.4±2.9 岁。基于线性混合模型，肝脂肪分数受年龄（-0.71%/+1 岁，p=0.0002）、肝体积（+0.006%/+1 mL，p<0.0001）、肝硬度（-2.80%/+1 kPa，p=0.0006）和血清 ALT（+0.02%/+1 U/L，p=0.0019）的影响。肝硬度受肝体积（+0.0003 kPa/+1 mL，p=0.001）、脂肪分数（-0.02 kPa/+1%脂肪，p=0.0006）和 ALT（0.002 kPa/+1 U/L，p=0.0002）的影响。肝体积受性别（女孩为-262.1 mL，p=0.0003）、年龄（+51.8 mL/+1 岁，p=0.0001）、BMI（+49.1 mL/+1 kg/m，p<0.0001）、脂肪分数（+30.5 mL/+1%脂肪，p<0.0001）、硬度（+192.6 mL/+1 kPa，p=0.001）和糖尿病状态（糖尿病患者为+518.94 mL，p=0.0009）的影响。
肝体积、脂肪分数和硬度相互关联，并与多个患者特定因素相关。这些关系需要进一步研究，因为 MRI 越来越多地被用作脂肪性肝病诊断和监测的非侵入性生物标志物。
