Makhija Nikhil, Vikram Naval K, Kaur Gurdeep, Sharma Raju, Srivastava Deep N, Madhusudhan Kumble S
Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 10029, India.
Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 10029, India.
J Clin Exp Hepatol. 2020 Mar-Apr;10(2):139-149. doi: 10.1016/j.jceh.2019.09.002. Epub 2019 Sep 20.
The aim of this study was to study the role of magnetic resonance imaging (MRI) in monitoring hepatic fat content in cases of nonalcoholic fatty liver disease (NAFLD).
41 adults (mean age: 39 years, 22 males; 19 females) with NAFLD were included after obtaining approval from the institutional ethics committee. The baseline clinical (weight, body mass index [BMI]) and biochemical parameters, fatty liver grade on ultrasonography (USG), and hepatic fat signal fraction (FSF) using dual-echo chemical shift imaging and proton density fat fraction on magnetic resonance spectroscopy (MRS-PDFF) were assessed, before and after intervention (dietary and lifestyle changes and oral vitamin E for six months). They were categorized into Group A (good compliance to intervention) and Group B (poor compliance), and the clinical and imaging parameters were compared between them.
After intervention, Group A (n = 30) showed significant reduction in BMI (28.35 ± 3.25 to 27.14 ± 3.24 kg/m; < 0.001), hepatic FSF (19.30 ± 9.09% to 11.18 ± 7.61%; < 0.05), and MRS-PDFF (18.79 ± 8.53% to 10.64 ± 6.66%). In Group B (n = 11), there was significant increase in BMI (28.85 ± 2.41 to 29.31 ± 2.57 kg/m; < 0.001), hepatic FSF (18.96 ± 9.79% to 21.48 ± 11.80%; < 0.05), and reduction in high-density lipoproteins ( < 0.05). Although there was good correlation between USG and MRS in quantifying liver fat (r = 0.84-0.87; < 0.001), USG was unable to detect <5.3% change in hepatic fat. There was poor correlation between lipid profile and MRS-PDFF. Change in body weight significantly correlated with change in hepatic fat content (r = 0.76; < 0.001).
MRI is useful in accurately quantifying and in monitoring hepatic fat content and is better than clinical and biochemical parameters and USG.
本研究旨在探讨磁共振成像（MRI）在监测非酒精性脂肪性肝病（NAFLD）患者肝脏脂肪含量中的作用。
经机构伦理委员会批准后，纳入41例NAFLD成年患者（平均年龄：39岁，男性22例；女性19例）。在干预前后（饮食和生活方式改变以及口服维生素E六个月），评估基线临床指标（体重、体重指数[BMI]）和生化参数、超声检查（USG）的脂肪肝分级，以及使用双回波化学位移成像的肝脏脂肪信号分数（FSF）和磁共振波谱（MRS-PDFF）的质子密度脂肪分数。将患者分为A组（对干预依从性好）和B组（对干预依从性差），并比较两组之间的临床和影像学参数。
干预后，A组（n = 30）的BMI显著降低（从28.35±3.25降至27.14±3.24 kg/m；P<0.001），肝脏FSF降低（从19.30±9.09%降至11.18±7.61%；P<0.05），MRS-PDFF降低（从18.79±8.53%降至10.64±6.66%）。在B组（n = 11）中，BMI显著增加（从28.85±2.41增至29.31±2.57 kg/m；P<0.001），肝脏FSF增加（从18.96±9.79%增至21.48±11.80%；P<0.05），高密度脂蛋白降低（P<0.05）。虽然USG与MRS在量化肝脏脂肪方面具有良好的相关性（r = 0.84 - 0. ..7），但USG无法检测到肝脏脂肪<5.3%的变化。血脂谱与MRS-PDFF之间的相关性较差。体重变化与肝脏脂肪含量变化显著相关（r = 0.76；P<0.001）。
MRI有助于准确量化和监测肝脏脂肪含量，优于临床和生化参数以及USG。
