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Diagnostic value of MRI proton density fat fraction for assessing liver steatosis in chronic viral C hepatitis.

Paparo F, Cenderello G, Revelli M, Bacigalupo L, Rutigliani M, Zefiro D, Cevasco L, Amico M, Bandelloni R, Cassola G, Forni GL, Rollandi GA - Biomed Res Int (2015)

Bottom Line: The median MRI PDFF showed a strong correlation with the histological fat fraction (FF) (r = 0.754, 95% CI 0.637 to 0.836, P < 0.0001), and the correlation was influenced by neither the liver stiffness nor the T2* decay.The median MRI PDFF result was significantly lower in the F4 subgroup (P < 0.05).Our MRI technique of PDFF estimation allowed discriminating with a good diagnostic accuracy between different grades of hepatic steatosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, E.O. Ospedali Galliera, Mura della Cappuccine 14, 16128 Genoa, Italy.

ABSTRACT

Objective: To assess the diagnostic performance of a T1-independent, T2*-corrected multiecho magnetic resonance imaging (MRI) technique for the quantification of hepatic steatosis in a cohort of patients affected by chronic viral C hepatitis, using liver biopsy as gold standard.

Methods: Eighty-one untreated patients with chronic viral C hepatitis were prospectively enrolled. All included patients underwent MRI, transient elastography, and liver biopsy within a time interval <10 days.

Results: Our cohort of 77 patients included 43/77 (55.8%) males and 34/77 (44.2%) females with a mean age of 51.31 ± 11.27 (18-81) years. The median MRI PDFF showed a strong correlation with the histological fat fraction (FF) (r = 0.754, 95% CI 0.637 to 0.836, P < 0.0001), and the correlation was influenced by neither the liver stiffness nor the T2* decay. The median MRI PDFF result was significantly lower in the F4 subgroup (P < 0.05). The diagnostic accuracy of MRI PDFF evaluated by AUC-ROC analysis was 0.926 (95% CI 0.843 to 0.973) for S ≥ 1 and 0.929 (95% CI 0.847 to 0.975) for S = 2.

Conclusions: Our MRI technique of PDFF estimation allowed discriminating with a good diagnostic accuracy between different grades of hepatic steatosis.

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Related in: MedlinePlus

Box-and-whisker plots for MRI PDFF measurements in relation to each grade of steatosis (a), fibrosis (b), and necroinflammatory activity (c). The top and the bottom of the boxes are the first and third quartiles, respectively. The length of the box represents the interquartile range including 50% of the values. The line through the middle of each box represents the median. The error shows the minimum and maximum values (range). An outside value (separate point) is defined as a value that is smaller than the lower quartile minus 1.5 times the interquartile range or larger than the upper quartile plus 1.5 times the interquartile range.
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fig4: Box-and-whisker plots for MRI PDFF measurements in relation to each grade of steatosis (a), fibrosis (b), and necroinflammatory activity (c). The top and the bottom of the boxes are the first and third quartiles, respectively. The length of the box represents the interquartile range including 50% of the values. The line through the middle of each box represents the median. The error shows the minimum and maximum values (range). An outside value (separate point) is defined as a value that is smaller than the lower quartile minus 1.5 times the interquartile range or larger than the upper quartile plus 1.5 times the interquartile range.

Mentions: The correlation of the mean MRI PDFF value with the histological FF was moderate (r = 0.624, 95% CI for rho 0.465 to 0.744, P < 0.0001), while the correlation of the median MRI PDFF value with the histological FF was strong (r = 0.754, 95% CI for rho 0.637 to 0.836, P < 0.0001). The median MRI PDFF values for each steatosis grade were: 4.3 (0.7–10.09) for S0; 10.4 (3.7–16.2) for S1; 13.5 (8.4–17.01) for S2 (P < 0.05) (Figures 2 and 3). Stratifying the cohort of patients according to the METAVIR stages of parenchymal fibrosis, the median MRI PDFF values resulted in significantly different among different subgroups (P < 0.05 with the Kruskal-Wallis test). The post-hoc analysis showed that the median MRI PDFF in the F4 subgroup was significantly lower than in the other subgroups of patients (P < 0.05) (Table 2). Stratifying the cohort of patients according to the METAVIR stages of necroinflammatory activity, the Kruskal-Wallis test did not reveal a significant difference among the median MRI PDFF values of the four subgroups of patients (P > 0.05) (Figure 4). Box-and-whisker plots for MRI PDFF measurements in relation to each grade of steatosis, fibrosis, and necroinflammatory activity are shown in Figure 4.


Diagnostic value of MRI proton density fat fraction for assessing liver steatosis in chronic viral C hepatitis.

Paparo F, Cenderello G, Revelli M, Bacigalupo L, Rutigliani M, Zefiro D, Cevasco L, Amico M, Bandelloni R, Cassola G, Forni GL, Rollandi GA - Biomed Res Int (2015)

Box-and-whisker plots for MRI PDFF measurements in relation to each grade of steatosis (a), fibrosis (b), and necroinflammatory activity (c). The top and the bottom of the boxes are the first and third quartiles, respectively. The length of the box represents the interquartile range including 50% of the values. The line through the middle of each box represents the median. The error shows the minimum and maximum values (range). An outside value (separate point) is defined as a value that is smaller than the lower quartile minus 1.5 times the interquartile range or larger than the upper quartile plus 1.5 times the interquartile range.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4383409&req=5

fig4: Box-and-whisker plots for MRI PDFF measurements in relation to each grade of steatosis (a), fibrosis (b), and necroinflammatory activity (c). The top and the bottom of the boxes are the first and third quartiles, respectively. The length of the box represents the interquartile range including 50% of the values. The line through the middle of each box represents the median. The error shows the minimum and maximum values (range). An outside value (separate point) is defined as a value that is smaller than the lower quartile minus 1.5 times the interquartile range or larger than the upper quartile plus 1.5 times the interquartile range.
Mentions: The correlation of the mean MRI PDFF value with the histological FF was moderate (r = 0.624, 95% CI for rho 0.465 to 0.744, P < 0.0001), while the correlation of the median MRI PDFF value with the histological FF was strong (r = 0.754, 95% CI for rho 0.637 to 0.836, P < 0.0001). The median MRI PDFF values for each steatosis grade were: 4.3 (0.7–10.09) for S0; 10.4 (3.7–16.2) for S1; 13.5 (8.4–17.01) for S2 (P < 0.05) (Figures 2 and 3). Stratifying the cohort of patients according to the METAVIR stages of parenchymal fibrosis, the median MRI PDFF values resulted in significantly different among different subgroups (P < 0.05 with the Kruskal-Wallis test). The post-hoc analysis showed that the median MRI PDFF in the F4 subgroup was significantly lower than in the other subgroups of patients (P < 0.05) (Table 2). Stratifying the cohort of patients according to the METAVIR stages of necroinflammatory activity, the Kruskal-Wallis test did not reveal a significant difference among the median MRI PDFF values of the four subgroups of patients (P > 0.05) (Figure 4). Box-and-whisker plots for MRI PDFF measurements in relation to each grade of steatosis, fibrosis, and necroinflammatory activity are shown in Figure 4.

Bottom Line: The median MRI PDFF showed a strong correlation with the histological fat fraction (FF) (r = 0.754, 95% CI 0.637 to 0.836, P < 0.0001), and the correlation was influenced by neither the liver stiffness nor the T2* decay.The median MRI PDFF result was significantly lower in the F4 subgroup (P < 0.05).Our MRI technique of PDFF estimation allowed discriminating with a good diagnostic accuracy between different grades of hepatic steatosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, E.O. Ospedali Galliera, Mura della Cappuccine 14, 16128 Genoa, Italy.

ABSTRACT

Objective: To assess the diagnostic performance of a T1-independent, T2*-corrected multiecho magnetic resonance imaging (MRI) technique for the quantification of hepatic steatosis in a cohort of patients affected by chronic viral C hepatitis, using liver biopsy as gold standard.

Methods: Eighty-one untreated patients with chronic viral C hepatitis were prospectively enrolled. All included patients underwent MRI, transient elastography, and liver biopsy within a time interval <10 days.

Results: Our cohort of 77 patients included 43/77 (55.8%) males and 34/77 (44.2%) females with a mean age of 51.31 ± 11.27 (18-81) years. The median MRI PDFF showed a strong correlation with the histological fat fraction (FF) (r = 0.754, 95% CI 0.637 to 0.836, P < 0.0001), and the correlation was influenced by neither the liver stiffness nor the T2* decay. The median MRI PDFF result was significantly lower in the F4 subgroup (P < 0.05). The diagnostic accuracy of MRI PDFF evaluated by AUC-ROC analysis was 0.926 (95% CI 0.843 to 0.973) for S ≥ 1 and 0.929 (95% CI 0.847 to 0.975) for S = 2.

Conclusions: Our MRI technique of PDFF estimation allowed discriminating with a good diagnostic accuracy between different grades of hepatic steatosis.

Show MeSH
Related in: MedlinePlus