Assessment of Nonalcoholic Fatty Liver Disease Progression in Children Using Magnetic Resonance Imaging

Mouzaki, Marialena; Trout, Andrew T.; Arce‐Clachar, Ana Catalina; Bramlage, Kristin; Kuhnell, Pierce; Dillman, Jonathan R.; Xanthakos, Stavra A.

doi:10.1016/j.jpeds.2018.05.024

Cited by 31 publications

(23 citation statements)

References 31 publications

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“…While ALT is considered an imprecise marker of liver disease severity, it is the tool of choice to screen for and monitor the progression of liver disease severity in the clinical setting . In our study, participants with class III obesity had higher serum ALT levels and increased odds of an ALT level > 80 U/L compared with participants with less obesity.…”

Section: Discussionmentioning

confidence: 99%

Severe obesity is associated with liver disease severity in pediatric non‐alcoholic fatty liver disease

et al. 2019

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Background: Paediatric non-alcoholic fatty liver disease (NAFLD) is highly prevalent among children with obesity. The primary objective of this study was determining whether obesity severity is associated with NAFLD severity. By using paediatric classifications for severe obesity, clinicians may be able to better risk stratify patients, which in turn would guide more effective management and treatment.Methods: Retrospective cohort study including patients followed at Cincinnati Children's Medical Center for NAFLD. Patients were categorized as overweight or class I, II, III obese based on established body mass index (BMI) cut-offs. Liver disease severity was determined using biochemical, imaging (magnetic resonance elastography [MRE]), and histologic evidence of liver injury.Results: Three cohorts were studied individually based on the method used to assess disease severity (biochemical n = 767, imaging n = 366, and histology n = 249). Between the three cohorts, there were significant differences in age, proportion of patients with class II and class III obesity, and serum alanine transaminase (ALT) levels. In the biochemistry cohort, the odds of having ALT > 80 U/L were highest in patients with class III obesity (P = .026). In the imaging cohort, liver stiffness was significantly different between BMI groups of patients (P = .001). In the histology cohort, those with class III obesity had significantly higher odds of NAFLD activity score (NAS) ≥ 5 (P = .012). Discussion:Obesity severity is associated with liver disease severity. Patients with more severe obesity are more likely to have more advanced liver disease, a finding that can assist in risk stratification, as well as monitoring and treatment approaches.

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Section: Discussionmentioning

confidence: 99%

Severe obesity is associated with liver disease severity in pediatric non‐alcoholic fatty liver disease

et al. 2019

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“…However, contrast‐enhanced US, although approved by the Food and Drug Administration and widely available, is labor intensive and costs more than standard US. Magnetic resonance elastography and US elastography have also been proposed as imaging methods for the detection of fibrosis and the monitoring of the progression of fatty liver disease . Both magnetic resonance elastography and US elastography are more time intensive and more expensive than a standard US evaluation of the liver.…”

Section: Discussionmentioning

confidence: 99%

“…Magnetic resonance elastography and US elastography have also been proposed as imaging methods for the detection of fibrosis and the monitoring of the progression of fatty liver disease. 21 Both magnetic resonance elastography and US elastography are more time intensive and more expensive than a standard US evaluation of the liver. The primary benefits of the US-FLI over these other modalities is reduced cost, a shorter examination time, and ease of use.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Fatty Liver Indicator: A Simple Tool for Differentiating Steatosis From Nonalcoholic Steatohepatitis: Validity in the Average Obese Population

Nelson

Hoskins

Lisanti

et al. 2019

J of Ultrasound Medicine

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Objectives Steatosis, nonalcoholic steatohepatitis (NASH), and fibrosis/cirrhosis represent a spectrum of fatty liver disease. The ultrasound fatty liver indicator (US‐FLI) evaluates ultrasound (US) features to identify stages of fatty liver disease. We hypothesized that US features could be independent predictors of NASH and that the US‐FLI differentiates steatosis from NASH in the average obese population. Methods A retrospective analysis of 208 patients with normal (n = 14), steatotic (n = 89), and NASH (n = 105) livers was performed. Liver/biliary disease and a history of alcohol intake were excluded. Ultrasound metrics included liver‐kidney contrast, posterior attenuation, vessel blurring, difficulty visualizing the gallbladder wall, difficulty visualizing the diaphragm, and areas of focal fatty sparing. A statistical comparison of the 3 groups as well as fibrosis stage I and II/III NASH groups was performed. Logistic regression identified independent predictors of NASH. Results Gallbladder wall visualization and vessel blurring were different between the steatosis and NASH groups (P ≤ .01). Gallbladder wall visualization was specific for NASH (89%), and vessel blurring was sensitive for NASH (93%). A US‐FLI score of 4 or lower suggested the absence of NASH (negative predictive value, 88%; sensitivity, 91%). Logistic regression revealed vessel blurring as the only US predictor of NASH (P ≤ .01). However, the area under the curve (0.649) showed poor performance in differentiating steatosis from NASH when the US‐FLI score was 5 or higher. Conclusions Our data suggest that the US‐FLI may differentiate steatosis from NASH in the average obese population. Vessel blurring and poor gallbladder wall visualization were the most important metrics. Identification of NASH was enhanced by including the US‐FLI score with vessel blurring.

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“…Mouzaki M et al 2018. 53 performed a research to evaluate disease advancement by using paired magnetic resonance imaging (MRI) measurement. 65 patients with NAFLD who underwent recurrent MRI studies were included in the study.…”

Section: F Study Reports Related To Diagnosis Of Nafldmentioning

confidence: 99%

A Recent Research on Non Alcoholic Fatty Liver Disease

2019

IJRTE

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Non alcoholic fatty liver disease (NAFLD) is a persistent condition of liver steatosis in the absence of alcohol consumption. The main risk factors associated with the disease are hypertension, diabetes mellitus and dyslipidemia these are together termed as metabolic syndrome. Recent studies identified that children are more vulnerable to develop NAFLD in future due to sedentary life styles and poor diet. NAFLD can further make complications of cardiovascular and liver related disorders. Apart from these causes there are factors such as enzyme, gene expression; amino acid regulation and so on in the human body plays an important role in the development of NAFLD. The objective of this research is to summaries the various ways by which a NAFLD is affected in a normal individual and to point out current research on treatment strategy for the NAFLD.

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Assessment of Nonalcoholic Fatty Liver Disease Progression in Children Using Magnetic Resonance Imaging

Abstract: MRI-determined hepatic FF and stiffness improved in a minority of patients overtime. ALT levels were not reflective of the change in FF or stiffness. MRI-based imaging is complementary in the assessment of NAFLD progression.

Cited by 31 publications

References 31 publications

Severe obesity is associated with liver disease severity in pediatric non‐alcoholic fatty liver disease

Severe obesity is associated with liver disease severity in pediatric non‐alcoholic fatty liver disease

Ultrasound Fatty Liver Indicator: A Simple Tool for Differentiating Steatosis From Nonalcoholic Steatohepatitis: Validity in the Average Obese Population

A Recent Research on Non Alcoholic Fatty Liver Disease

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