Multiparametric MR Is a Valuable Modality for Evaluating Disease Severity of Nonalcoholic Fatty Liver Disease

Abstract

INTRODUCTION: Because nonalcoholic fatty liver disease (NAFLD) is becoming a leading cause of chronic liver disease, noninvasive evaluations of its severity are immediately needed. This prospective cross-sectional study evaluated the effectiveness of noninvasive assessments of hepatic steatosis, fibrosis, and steatohepatitis. METHODS: Patients underwent laboratory tests, liver biopsy, transient elastography, and MRI. Multiparametric MR was used to measure MRI proton density fat fraction, MR spectroscopy, T1 mapping, and MR elastography (MRE). RESULTS: We enrolled 130 patients between October 2016 and July 2019. For the diagnosis of moderate-to-severe steatosis (grade ≥ 2), the area under the receiver operating characteristic curve (AUROC) was lower in controlled attenuation parameter (0.69; 95% confidence interval [CI], 0.60–0.76) than MRI proton density fat fraction (0.82; 95% CI, 0.75–0.89; P = 0.008) and MR spectroscopy (0.83; 95% CI, 0.75–0.89; P = 0.006). For the diagnosis of advanced fibrosis (stage ≥ 3), the AUROC of MRE (0.89; 95% CI, 0.83–0.94) was superior compared with those of the Fibrosis-4 index (0.77; 95% CI, 0.69–0.84; P = 0.010), NAFLD fibrosis score (0.81; 95% CI, 0.73–0.87; P = 0.043), and transient elastography (0.82; 95% CI, 0.74–0.88; P = 0.062). For detecting advanced fibrosis or nonalcoholic steatohepatitis, the AUROC of MRE (0.86; 95% CI, 0.79–0.91) was higher than that of TE (0.76; 95% CI, 0.68–0.83) with statistical significance (P = 0.018). DISCUSSION: Multiparametric MR accurately identified a severe form of NAFLD. Multiparametric MR can be a valuable noninvasive method for evaluating the severity of NAFLD.

Diagnostic accuracy of elastography and magnetic resonance imaging in patients with NAFLD: A systematic review and meta-analysis

“…The characteristics of the VCTE , MRE [39,49,62,[81][82][83][84][85][86][87][88][89], pSWE [19,24,25,42,47,50,84,[90][91][92][93][94], 2DSWE [25,47,95,96], and MRI [30,36,63,97] studies included in the systematic review are summarised in Table 1. There were 73 prospective studies and 9 retrospective studies.…”

Heightened Plasma Levels of Transforming Growth Factor Beta (TGF-β) and Increased Degree of Systemic Biochemical Perturbation Characterizes Hepatic Steatosis in Overweight Pediatric Patients: A Cross-Sectional Study

“…Furthermore, this finding is especially important given that the adolescents studied here were mostly severely obese and traditional biochemical markers such as triglycerides, HDL-c, insulinemia, and HOMA-IR were not able to adequately identify presence of hepatic steatosis. Usually, the assessment of the disease severity is based on noninvasive radiologic examination, specifically ultrasonography [ 56 ]. However, this method is subject to errors depending on the operator.…”

Multiparametric MR mapping in clinical decision-making for diffuse liver disease

“…Multiparametric MRI refers to use of multiple quantitative (parametric) MRI features or measures with several possibilities for combinations [34][35][36][40][41][42][43][44][45]. Therefore, these combinations could be used to evaluate two or more specific characteristics of chronic liver disease and diffuse liver processes, to include derivation of composite metrics [44,46].…”