Idilman Ilkay S, Low Hsien Min, Gidener Tolga, Philbrick Kenneth, Mounajjed Taofic, Li Jiahui, Allen Alina M, Yin Meng, Venkatesh Sudhakar K
Division of Abdominal Imaging, Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
Department of Radiology, School of Medicine, Hacettepe University, Ankara 06100, Turkey.
J Clin Med. 2021 Jun 10;10(12):2565. doi: 10.3390/jcm10122565.
(1) Purpose: To determine the association between visceral adipose tissue (VAT) and proton density fat fraction (PDFF) with magnetic resonance imaging (MRI), and hepatic steatosis (HS), non-alcoholic steatohepatitis (NASH) and hepatic fibrosis (HF) in patients with known or suspected non-alcoholic fatty liver disease (NAFLD). (2) Methods: 135 subjects that had a liver biopsy performed within 3 months (bariatric cohort) or 1 month (NAFLD cohort) of an MRI exam formed the study group. VAT volume was quantified at L2-L3 level on opposed-phase images with signal intensity-based painting using a semi-quantitative software. Liver PDFF and pancreas PDFF were calculated on fat fraction maps. Liver volume (Lvol) and spleen volume (Svol) were also calculated using a semi-automated 3D volume tool available on PACS. A histological analysis was performed by an expert hepatopathologist blinded to imaging findings. (3) Results: The mean Lvol, Svol, liver PDFF, pancreas PDFF and VAT of the study population were 2492.2 mL, 381.6 mL, 13.2%, 12.7% and 120.6 mL, respectively. VAT showed moderate correlation with liver PDFF (r = 0.41, < 0.001) and weak correlation with Lvol (r = 0.38, < 0.001), Svol (r = 0.20, = 0.025) and pancreas PDFF (r = 0.29, = 0.001). VAT, Lvol and liver PDFF were significantly higher in patients with HS ( < 0.001), NASH ( < 0.05) and HF ( < 0.05). VAT was also significantly higher in the presence of lobular inflammation ( = 0.019) and hepatocyte ballooning ( = 0.001). The cut-off VAT volumes for predicting HS, NASH and HF were 101.8 mL (AUC, 0.7), 111.8 mL (AUC, 0.64) and 111.6 mL (AUC, 0.66), respectively. (4) Conclusion: The MRI determined VAT can be used for predicting the presence of HS, NASH and HF in patients with known or suspected NAFLD.
（1）目的：利用磁共振成像（MRI）确定已知或疑似非酒精性脂肪性肝病（NAFLD）患者的内脏脂肪组织（VAT）和质子密度脂肪分数（PDFF）与肝脂肪变性（HS）、非酒精性脂肪性肝炎（NASH）及肝纤维化（HF）之间的关联。（2）方法：135名在MRI检查后3个月内（减重手术队列）或1个月内（NAFLD队列）接受肝活检的受试者组成研究组。使用基于信号强度绘制的半定量软件，在L2-L3水平的反相位图像上对VAT体积进行定量。在脂肪分数图上计算肝脏PDFF和胰腺PDFF。还使用PACS上可用的半自动3D体积工具计算肝脏体积（Lvol）和脾脏体积（Svol）。由对影像结果不知情的专业肝病病理学家进行组织学分析。（3）结果：研究人群的平均Lvol、Svol、肝脏PDFF、胰腺PDFF和VAT分别为2492.2 mL、381.6 mL、13.2%、12.7%和120.6 mL。VAT与肝脏PDFF呈中度相关（r = 0.41，P < 0.001），与Lvol呈弱相关（r = 0.38，P < 0.001），与Svol呈弱相关（r = 0.20，P = 0.025），与胰腺PDFF呈弱相关（r = 0.29，P = 0.001）。HS（P < 0.001）、NASH（P < 0.05）和HF（P < 0.05）患者的VAT、Lvol和肝脏PDFF显著更高。在存在小叶炎症（P = 0.019）和肝细胞气球样变（P = 0.001）时，VAT也显著更高。预测HS、NASH和HF的VAT体积截断值分别为101.8 mL（AUC，0.7）、111.8 mL（AUC，0.64）和111.6 mL（AUC，0.66）。（4）结论：MRI测定的VAT可用于预测已知或疑似NAFLD患者中HS、NASH和HF的存在。
