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Erschienen in: Abdominal Radiology 5/2018

21.08.2017

Quantitative MRI of fatty liver disease in a large pediatric cohort: correlation between liver fat fraction, stiffness, volume, and patient-specific factors

verfasst von: Madalsa Joshi, Jonathan R. Dillman, Kamalpreet Singh, Suraj D. Serai, Alexander J. Towbin, Stavra Xanthakos, Bin Zhang, Weizhe Su, Andrew T. Trout

Erschienen in: Abdominal Radiology | Ausgabe 5/2018

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Abstract

Purpose

Magnetic resonance imaging (MRI) techniques are increasingly used to quantify and monitor liver tissue characteristics including fat fraction, stiffness, and liver volume. The purpose of this study was to assess the inter-relationships between multiple quantitative liver metrics and patient-specific factors in a large pediatric cohort with known or suspected fatty liver disease.

Materials and methods

In this IRB-approved, HIPAA-compliant study, we retrospectively reviewed patient data and quantitative liver MRI results in children with known/suspected fatty liver disease. Relationships between liver MRI tissue characteristics and patient variables [sex, age, body mass index (BMI), diabetic status (no diabetes mellitus, insulin resistance/“prediabetes” diagnosis, or confirmed diabetes mellitus), and serum alanine transaminase (ALT)] were assessed using linear mixed models.

Results

294 quantitative liver MRI examinations were performed in 202 patients [128/202 (63.4%) boys], with a mean age of 13.4 ± 2.9 years. Based on linear mixed models, liver fat fraction was influenced by age (−0.71%/+1 year, p = 0.0002), liver volume (+0.006%/+1 mL, p < 0.0001), liver stiffness (−2.80%/+1 kPa, p = 0.0006), and serum ALT (+0.02%/+1 U/L, p = 0.0019). Liver stiffness was influenced by liver volume (+0.0003 kPa/+1 mL, p = 0.001), fat fraction (−0.02 kPa/+1% fat, p = 0.0006), and ALT (0.002 kPa/+1 U/L, p = 0.0002). Liver volume was influenced by sex (−262.1 mL for girls, p = 0.0003), age (+51.8 mL/+1 year, p = 0.0001), BMI (+49.1 mL/+1 kg/m2, p < 0.0001), fat fraction (+30.5 mL/+1% fat, p < 0.0001), stiffness (+192.6 mL/+1 kPa, p = 0.001), and diabetic status (+518.94 mL for diabetics, p = 0.0009).

Conclusions

Liver volume, fat fraction, and stiffness are inter-related and associated with multiple patient-specific factors. These relationships warrant further study as MRI is increasingly used as a non-invasive biomarker for fatty liver disease diagnosis and monitoring.
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Literatur
1.
Zurück zum Zitat Kramer H, Pickhardt PJ, Kliewer MA, et al. (2017) Accuracy of liver fat quantification with advanced CT, MRI, and ultrasound techniques: prospective comparison with MR spectroscopy. AJR Am J Roentgenol. 208(1):92–100CrossRefPubMed Kramer H, Pickhardt PJ, Kliewer MA, et al. (2017) Accuracy of liver fat quantification with advanced CT, MRI, and ultrasound techniques: prospective comparison with MR spectroscopy. AJR Am J Roentgenol. 208(1):92–100CrossRefPubMed
2.
Zurück zum Zitat Petitclerc L, Sebastiani G, Gilbert G, et al. (2017) Liver fibrosis: review of current imaging and MRI quantification techniques. J Magn Reson Imaging. 45(5):1276–1295CrossRefPubMed Petitclerc L, Sebastiani G, Gilbert G, et al. (2017) Liver fibrosis: review of current imaging and MRI quantification techniques. J Magn Reson Imaging. 45(5):1276–1295CrossRefPubMed
3.
Zurück zum Zitat Srinivasa Babu A, Wells ML, Teytelboym OM, et al. (2016) Elastography in chronic liver disease: modalities, techniques, limitations, and future directions. Radiographics. 36(7):1987–2006CrossRefPubMedPubMedCentral Srinivasa Babu A, Wells ML, Teytelboym OM, et al. (2016) Elastography in chronic liver disease: modalities, techniques, limitations, and future directions. Radiographics. 36(7):1987–2006CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Yin M, Glaser KJ, Talwalkar JA, et al. (2016) Hepatic MR elastography: clinical performance in a series of 1377 consecutive examinations. Radiology. 278(1):114–124CrossRefPubMed Yin M, Glaser KJ, Talwalkar JA, et al. (2016) Hepatic MR elastography: clinical performance in a series of 1377 consecutive examinations. Radiology. 278(1):114–124CrossRefPubMed
5.
Zurück zum Zitat Towbin AJ, Serai SD, Podberesky DJ (2013) Magnetic resonance imaging of the pediatric liver: imaging of steatosis, iron deposition, and fibrosis. Magn Reson Imaging Clin N Am. 21(4):669–680CrossRefPubMed Towbin AJ, Serai SD, Podberesky DJ (2013) Magnetic resonance imaging of the pediatric liver: imaging of steatosis, iron deposition, and fibrosis. Magn Reson Imaging Clin N Am. 21(4):669–680CrossRefPubMed
6.
Zurück zum Zitat Trout AT, Serai S, Mahley AD, et al. (2016) Liver stiffness Measurements with MR elastography: agreement and repeatability across imaging systems, field strengths, and pulse sequences. Radiology. 281(3):793–804CrossRefPubMed Trout AT, Serai S, Mahley AD, et al. (2016) Liver stiffness Measurements with MR elastography: agreement and repeatability across imaging systems, field strengths, and pulse sequences. Radiology. 281(3):793–804CrossRefPubMed
7.
Zurück zum Zitat Manduca A, Oliphant TE, Dresner MA, et al. (2001) Magnetic resonance elastography: non-invasive mapping of tissue elasticity. Med Image Anal. 5(4):237–254CrossRefPubMed Manduca A, Oliphant TE, Dresner MA, et al. (2001) Magnetic resonance elastography: non-invasive mapping of tissue elasticity. Med Image Anal. 5(4):237–254CrossRefPubMed
8.
Zurück zum Zitat Pavlides M, Banerjee R, Tunnicliffe EM, et al. (2016) Multi-parametric magnetic resonance imaging for the assessment of non-alcoholic fatty liver disease severity. Liver Int. 37(7):1065–1073CrossRef Pavlides M, Banerjee R, Tunnicliffe EM, et al. (2016) Multi-parametric magnetic resonance imaging for the assessment of non-alcoholic fatty liver disease severity. Liver Int. 37(7):1065–1073CrossRef
9.
Zurück zum Zitat Leitao HS, Doblas S, Garteiser P, et al. (2017) Hepatic fibrosis, inflammation, and steatosis: influence on the MR viscoelastic and diffusion parameters in patients with chronic liver disease. Radiology. 283(1):98–107CrossRefPubMed Leitao HS, Doblas S, Garteiser P, et al. (2017) Hepatic fibrosis, inflammation, and steatosis: influence on the MR viscoelastic and diffusion parameters in patients with chronic liver disease. Radiology. 283(1):98–107CrossRefPubMed
10.
Zurück zum Zitat Loomba R, Wolfson T, Ang B, et al. (2014) Magnetic resonance elastography predicts advanced fibrosis in patients with nonalcoholic fatty liver disease: a prospective study. Hepatology. 60(6):1920–1928CrossRefPubMedPubMedCentral Loomba R, Wolfson T, Ang B, et al. (2014) Magnetic resonance elastography predicts advanced fibrosis in patients with nonalcoholic fatty liver disease: a prospective study. Hepatology. 60(6):1920–1928CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Chen J, Talwalkar JA, Yin M, et al. (2011) Early detection of nonalcoholic steatohepatitis in patients with nonalcoholic fatty liver disease by using MR elastography. Radiology. 259(3):749–756CrossRefPubMedPubMedCentral Chen J, Talwalkar JA, Yin M, et al. (2011) Early detection of nonalcoholic steatohepatitis in patients with nonalcoholic fatty liver disease by using MR elastography. Radiology. 259(3):749–756CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Patel NS, Hooker J, Gonzalez M, et al. (2017) Weight loss decreases magnetic resonance elastography estimated liver stiffness in nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 15(3):463–464CrossRefPubMed Patel NS, Hooker J, Gonzalez M, et al. (2017) Weight loss decreases magnetic resonance elastography estimated liver stiffness in nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 15(3):463–464CrossRefPubMed
13.
Zurück zum Zitat Patel NS, Doycheva I, Peterson MR, et al. (2015) Effect of weight loss on magnetic resonance imaging estimation of liver fat and volume in patients with nonalcoholic steatohepatitis. Clin Gastroenterol Hepatol. 13(3):561–568CrossRefPubMed Patel NS, Doycheva I, Peterson MR, et al. (2015) Effect of weight loss on magnetic resonance imaging estimation of liver fat and volume in patients with nonalcoholic steatohepatitis. Clin Gastroenterol Hepatol. 13(3):561–568CrossRefPubMed
14.
Zurück zum Zitat Macaluso FS, Maida M, Camma C, et al. (2014) Steatosis affects the performance of liver stiffness measurement for fibrosis assessment in patients with genotype 1 chronic hepatitis C. J Hepatol. 61(3):523–529CrossRefPubMed Macaluso FS, Maida M, Camma C, et al. (2014) Steatosis affects the performance of liver stiffness measurement for fibrosis assessment in patients with genotype 1 chronic hepatitis C. J Hepatol. 61(3):523–529CrossRefPubMed
15.
Zurück zum Zitat Petta S, Maida M, Macaluso FS, et al. (2015) The severity of steatosis influences liver stiffness measurement in patients with nonalcoholic fatty liver disease. Hepatology. 62(4):1101–1110CrossRefPubMed Petta S, Maida M, Macaluso FS, et al. (2015) The severity of steatosis influences liver stiffness measurement in patients with nonalcoholic fatty liver disease. Hepatology. 62(4):1101–1110CrossRefPubMed
16.
Zurück zum Zitat Conti F, Vukotic R, Foschi FG, et al. (2016) Transient elastography in healthy subjects and factors influencing liver stiffness in non-alcoholic fatty liver disease: an Italian community-based population study. Dig Liver Dis. 48(11):1357–1363CrossRefPubMed Conti F, Vukotic R, Foschi FG, et al. (2016) Transient elastography in healthy subjects and factors influencing liver stiffness in non-alcoholic fatty liver disease: an Italian community-based population study. Dig Liver Dis. 48(11):1357–1363CrossRefPubMed
17.
Zurück zum Zitat Guo Y, Dong C, Lin H, et al. (2017) Ex vivo study of acoustic radiation force impulse imaging elastography for evaluation of rat liver with steatosis. Ultrasonics. 74:161–166CrossRefPubMed Guo Y, Dong C, Lin H, et al. (2017) Ex vivo study of acoustic radiation force impulse imaging elastography for evaluation of rat liver with steatosis. Ultrasonics. 74:161–166CrossRefPubMed
18.
Zurück zum Zitat Kang BK, Lee SS, Cheong H, et al. (2015) Shear wave elastography for assessment of steatohepatitis and hepatic fibrosis in rat models of non-alcoholic fatty liver disease. Ultrasound Med Biol. 41(12):3205–3215CrossRefPubMed Kang BK, Lee SS, Cheong H, et al. (2015) Shear wave elastography for assessment of steatohepatitis and hepatic fibrosis in rat models of non-alcoholic fatty liver disease. Ultrasound Med Biol. 41(12):3205–3215CrossRefPubMed
19.
Zurück zum Zitat Silva M, Marques M, Cardoso H, et al. (2016) Glycogenic hepatopathy in young adults: a case series. Rev Esp Enferm Dig. 108(10):673–676PubMed Silva M, Marques M, Cardoso H, et al. (2016) Glycogenic hepatopathy in young adults: a case series. Rev Esp Enferm Dig. 108(10):673–676PubMed
20.
Zurück zum Zitat DiPaola FW, Schumacher KR, Goldberg CS, et al. (2017) Effect of Fontan operation on liver stiffness in children with single ventricle physiology. Eur Radiol. 27(6):2434–2442CrossRefPubMed DiPaola FW, Schumacher KR, Goldberg CS, et al. (2017) Effect of Fontan operation on liver stiffness in children with single ventricle physiology. Eur Radiol. 27(6):2434–2442CrossRefPubMed
21.
Zurück zum Zitat Serai SD, Dillman JR, Trout AT (2017) Proton density fat fraction measurements at 1.5- and 3-T hepatic MR imaging: same-day agreement among readers and across two imager manufacturers. Radiology. 284(1):244–254. doi:10.1148/radiol.2017161786 CrossRefPubMed Serai SD, Dillman JR, Trout AT (2017) Proton density fat fraction measurements at 1.5- and 3-T hepatic MR imaging: same-day agreement among readers and across two imager manufacturers. Radiology. 284(1):244–254. doi:10.​1148/​radiol.​2017161786 CrossRefPubMed
Metadaten
Titel
Quantitative MRI of fatty liver disease in a large pediatric cohort: correlation between liver fat fraction, stiffness, volume, and patient-specific factors
verfasst von
Madalsa Joshi
Jonathan R. Dillman
Kamalpreet Singh
Suraj D. Serai
Alexander J. Towbin
Stavra Xanthakos
Bin Zhang
Weizhe Su
Andrew T. Trout
Publikationsdatum
21.08.2017
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 5/2018
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-017-1289-y

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