Assessment of Hepatic Steatosis in Patients Undergoing Liver Resection: Comparison of US, CT, T1-weighted Dual-Echo MR Imaging, and Point-resolved¹H MR Spectroscopy

Abstract

In contrast to US and CT, T1-weighted MR imaging and (1)H MR spectroscopy strongly correlate with histopathologic steatosis assessment and are able to demonstrate differences across steatosis grades. T1-weighted dual-echo MR imaging and (1)H MR spectroscopy had the best diagnostic accuracy in depicting hepatic steatosis.

Comparative Study of Ultrasonography, Computed Tomography, Magnetic Resonance Imaging, and Magnetic Resonance Spectroscopy for the Diagnosis of Fatty Liver in a Rat Model

“…and 87.1-91%, respectively, while those of MRS are 80.0-91.0% and 80.2-87.0%, respectively (18,26). Although the sensitivity and specificity of MRI and MRS in our study were similar to those reported earlier, MRS yielded higher diagnostic accuracy in this study.…”

“…However, our results proved the diagnostic performance of these modalities for distinguishing normal liver from mild fatty livers. Second, we did not consider the effect of microvesicular fatty liver on the diagnostic performance of these imaging techniques because macrovesicular fatty liver is clinically more relevant as a risk factor in liver surgery and transplantation (18).…”

“…Several studies have used US, CT, and MRI to evaluate a fatty liver (9)(10)(11)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32). Some studies have compared two or three imaging modalities for the diagnosis of a fatty liver (13,18,29,30,32,33).…”

“…Some studies have compared two or three imaging modalities for the diagnosis of a fatty liver (13,18,29,30,32,33). To the best of our knowledge, there is no study that has compared all imaging modalities [i.e., US, single-energy CT (SECT), dual-energy CT (DECT), MRI, and MRS].…”

US Cannot Be Used to Predict the Presence or Severity of Hepatic Steatosis in Severely Obese Adolescents

“…Presence of substantial (moderate to severe) hepatic steatosis was defi ned as more than 7.7% LFC. Both cutoffs have been validated to correspond with greater than 5% and greater than 33% fat containing hepatocytes at liver biopsy, respectively ( 21,22 ). Proton MR spectra were analyzed by a research fellow (A.E.B., 3 years of experience) with the supervision of an MR physicist (A.J.N., 8 years of experience), and both were blinded to the results of the US liver examination.…”