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01.06.2013 | Gastrointestinal

Evaluation of liver fat in the presence of iron with MRI using T2* correction: a clinical approach

verfasst von: Henninger Benjamin, Kremser Christian, Rauch Stefan, Eder Robert, Judmaier Werner, Zoller Heinz, Michaely Henrik, Schocke Michael

Erschienen in: European Radiology | Ausgabe 6/2013

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Abstract

Objectives

To assess magnetic resonance imaging (MRI) with conventional chemical shift-based sequences with and without T2* correction for the evaluation of steatosis hepatitis (SH) in the presence of iron.

Methods

Thirty-one patients who underwent MRI and liver biopsy because of clinically suspected diffuse liver disease were retrospectively analysed. The signal intensity (SI) was calculated in co-localised regions of interest (ROIs) using conventional spoiled gradient-echo T1 FLASH in-phase and opposed-phase (IP/OP). T2* relaxation time was recorded in a fat-saturated multi-echo-gradient-echo sequence. The fat fraction (FF) was calculated with non-corrected and T2*-corrected SIs. Results were correlated with liver biopsy.

Results

There was significant difference (P < 0.001) between uncorrected and T2* corrected FF in patients with SH and concomitant hepatic iron overload (HIO). Using 5 % as a threshold resulted in eight false negative results with uncorrected FF whereas T2* corrected FF lead to true positive results in 5/8 patients. ROC analysis calculated three threshold values (8.97 %, 5.3 % and 3.92 %) for T2* corrected FF with accuracy 84 %, sensitivity 83–91 % and specificity 63–88 %.

Conclusions

FF with T2* correction is accurate for the diagnosis of hepatic fat in the presence of HIO. Findings of our study suggest the use of IP/OP imaging in combination with T2* correction.

Key Points

• Magnetic resonance helps quantify both iron and fat content within the liver

• T2* correction helps to predict the correct diagnosis of steatosis hepatitis

• “Fat fraction” from T2*-corrected chemical shift-based sequences accurately quantifies hepatic fat

• “Fat fraction” without T2* correction underestimates hepatic fat with iron overload

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Titel: Evaluation of liver fat in the presence of iron with MRI using T2* correction: a clinical approach
verfasst von: Henninger Benjamin
Kremser Christian
Rauch Stefan
Eder Robert
Judmaier Werner
Zoller Heinz
Michaely Henrik
Schocke Michael
Publikationsdatum: 01.06.2013
Verlag: Springer-Verlag
Erschienen in: European Radiology / Ausgabe 6/2013
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-012-2745-2

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Evaluation of liver fat in the presence of iron with MRI using T2* correction: a clinical approach