Normal range for MR elastography measured liver stiffness in children without liver disease

Sawh, Mary Catherine; Newton, Kimberly P.; Goyal, Nidhi; Ángeles, Jorge; Harlow, Kathryn E.; Bross, Craig; Schlein, Alexandra; Hooker, Jonathan; Sy, Ethan; Glaser, Kevin J.; Yin, Min-Jean; Ehman, Richard L.; Sirlin, Claude B.; Schwimmer, Jeffrey B.

doi:10.1002/jmri.26905

Cited by 29 publications

(18 citation statements)

References 38 publications

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“…The previously validated IDEAL method was used during the MRI scans, which consisted of separating water and fat components divided by the sum of the fat and water components using chemical-shift MRI [ 19 ]. Liver fibrosis was measured by Magnetic Resonance Elastography (MRE), a non-invasive technology for measuring tissue stiffness that can determine the presence and stage of liver fibrosis by analyzing the propagation of shear waves transmitted into the abdomen [ 20 ]. This magnetic resonance imaging technique has been validated against liver fibrosis determined by liver biopsy.…”

Section: Methodsmentioning

confidence: 99%

“…This magnetic resonance imaging technique has been validated against liver fibrosis determined by liver biopsy. We used the pediatric population threshold previously proposed by Schwimmer et al, which considers adolescents with MRE values of <2.74 kPa to have no fibrosis; while MRE values of ≥2.74 kPa have stage 1 or greater fibrosis [ 20 ].…”

Section: Methodsmentioning

confidence: 99%

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PNPLA3 Genotype, Arachidonic Acid Intake, and Unsaturated Fat Intake Influences Liver Fibrosis in Hispanic Youth with Obesity

et al. 2021

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Non-alcoholic fatty liver disease impacts 15.2% of Hispanic adolescents and can progress to a build-up of scared tissue called liver fibrosis. If diagnosed early, liver fibrosis may be reversible, so it is necessary to understand risk factors. The aims of this study in 59 Hispanic adolescents with obesity were to: (1) identify potential biological predictors of liver fibrosis and dietary components that influence liver fibrosis, and (2) determine if the association between dietary components and liver fibrosis differs by PNPLA3 genotype, which is highly prevalent in Hispanic adolescents and associated with elevated liver fat. We examined liver fat and fibrosis, genotyped for PNPLA3 gene, and assessed diet via 24-h diet recalls. The prevalence of increased fibrosis was 20.9% greater in males, whereas participants with the GG genotype showed 23.7% greater prevalence. Arachidonic acid was associated with liver fibrosis after accounting for sex, genotype, and liver fat (β = 0.072, p = 0.033). Intakes of several dietary types of unsaturated fat have different associations with liver fibrosis by PNPLA3 genotype after accounting for sex, caloric intake, and liver fat. These included monounsaturated fat (βCC/CG = −0.0007, βGG = 0.03, p-value = 0.004), polyunsaturated fat (βCC/CG = −0.01, βGG = 0.02, p-value = 0.01), and omega-6 (βCC/CG = −0.0102, βGG = 0.028, p-value = 0.01). Results from this study suggest that reduction of arachidonic acid and polyunsaturated fatty acid intake might be important for the prevention of non-alcoholic fatty liver disease progression, especially among those with PNPLA3 risk alleles.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

PNPLA3 Genotype, Arachidonic Acid Intake, and Unsaturated Fat Intake Influences Liver Fibrosis in Hispanic Youth with Obesity

et al. 2021

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“…In order to develop normative data for MRE in children, Sawh et al evaluated 81 children free from liver disease by history, exam, laboratory analyses, and liver MRI-PDFF. 12 Depending upon the MRE threshold value used, 74% to 85% of healthy children free from the liver disease were correctly identified as not having any liver fibrosis. In the STEATOSIS study, Goyal et al also evaluated the stability of MRE derived shear stiffness over 12 weeks.…”

Section: Controlled Attenuation Parameter (Cap) Is a Technique That Usesmentioning

confidence: 99%

Recent advances in the epidemiology of nonalcoholic fatty liver disease in children

2021

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Children with obesity are at risk for numerous health problems, including nonalcoholic fatty liver disease (NAFLD). This review focuses on progress made in the epidemiology of NAFLD in children for the years 2015-2020. The estimated prevalence of NAFLD in children with obesity is 26%. The incidence of NAFLD in children has risen rapidly over the past decade. An understanding of the reasons for this rise is incomplete, but over the past 5 years, many studies have provided additional insight into the complexity of risk factors, diagnostic approaches, and associated comorbidities. Risk factors for NAFLD are wide-ranging, including perinatal factors involving both the mother and newborn, as well as environmental toxin exposure.Progress made in the noninvasive assessment will be critical to improving issues related to variability in approach to screening and diagnosis of NAFLD in children.The list of serious comorbidities observed in children with NAFLD continues to grow.Notably, for many of these conditions, such as diabetes and depression, the rates observed have exceeded the rates reported in children with obesity without NAFLD.Recent advancements reviewed show an increased awareness of this problem, while also calling attention to the need for additional research to guide successful efforts at prevention and treatment.

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“…Nevertheless, a more recent study performed on 71 healthy pediatric volunteers revealed a mean liver stiffness value of 2.1 kPa, pointing out that sex, age, or BMI had no impact on liver stiffness measurement [34]. MRE of liver uses mechanically generated shear waves, which are propagated into the liver and their images are obtained using a modified phase contrast MRI sequence, further converted into tissue stiffness maps or elastograms based on an inversion algorithm [32,33]. It is important to mention that the propagation of these shear waves occurs faster in stiffer tissue than in softer tissue, i.e., in cirrhotic tissue as compared to normal liver.…”

Section: Current Elastography Methodsmentioning

confidence: 99%

Elastography—A Bona Fide Non-Invasive Method for Assessing Non-Alcoholic Fatty Liver Disease in Children

2021

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Pediatric obesity has become a major public health problem worldwide, resulting in a wide spectrum of systemic complications. Liver disease associated with obesity, also known as nonalcoholic fatty liver disease (NAFLD), is currently the most common chronic liver condition in children. Therefore, its timely and proper diagnosis is essential for preventing further development of cirrhosis. Multiple studies focused on identifying the most accurate non-invasive diagnostic method for liver fibrosis or cirrhosis. Although liver biopsy remains the gold-standard in terms of this hepatopathy, elastography methods emerged as a relatively reliable alternative to liver biopsy. Thus, recent studies revealed the great importance of these non-invasive methods not only in diagnosing pediatric NAFLD, but also in its staging. MRE is commonly considered to have a greater accuracy than ultrasound-based elastography methods, but with lower availability and higher costs. Ultrasound-based elastography methods (transient elastography (TE), p-SWE, and 2-dimensional shear wave elastography (2D-SWE)) were proved to have similar accuracy in NAFLD staging. Nevertheless, multiple confounding factors account for potential challenges when using elastography for liver stiffness measurement, such as age, obesity itself (i.e., BMI), transaminase levels, or portal flow. A potential solution for facing these challenges might be represented by a complex approach based on the combination between elastography, clinical and laboratory findings. Although the studies that assessed the role of elastography in pediatric NAFLD staging are scarce, the current knowledge underlines a crucial role of these techniques taking into account their ability to distinguish between fibrosis degrees, their non-invasive patterns, lower costs and side effects when compared to liver biopsy. Therefore, elastography might become a cornerstone in staging pediatric NAFLD.

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Normal range for MR elastography measured liver stiffness in children without liver disease

Cited by 29 publications

References 38 publications

PNPLA3 Genotype, Arachidonic Acid Intake, and Unsaturated Fat Intake Influences Liver Fibrosis in Hispanic Youth with Obesity

PNPLA3 Genotype, Arachidonic Acid Intake, and Unsaturated Fat Intake Influences Liver Fibrosis in Hispanic Youth with Obesity

Recent advances in the epidemiology of nonalcoholic fatty liver disease in children

Elastography—A Bona Fide Non-Invasive Method for Assessing Non-Alcoholic Fatty Liver Disease in Children

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