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ORIGINAL ARTICLE   

Il Giornale Italiano di Radiologia Medica 2018 Gennaio-Febbraio;5(1):81-7

DOI: 10.23736/S2283-8376.18.00022-0

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: Italian

Liver steatosis quantification by means of dual-phase and multiecho gradient-echo magnetic resonance imaging: comparison with 1H spectroscopy

Giulia BESUTTI 1 , Guido LIGABUE 2, Luca NOCETTI 3, Chiara STENTARELLI 4, Giovanni GUARALDI 4, Stefano ZONA 4, Pietro TORRICELLI 2

1 Clinical and Experimental Medicine PHD Program, Università di Modena e Reggio Emilia, Modena, Italia; 2 Struttura Complessa di Diagnostica per Immagini, Dipartimento di Medicina Diagnostica, Clinica e Sanità Pubblica, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italia; 3 Servizio di Fisica Medica, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italia; 4 Struttura Complessa di Malattie Infettive, Dipartimento di Medicina, Medicina d’Urgenza e Specialità Mediche, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italia


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BACKGROUND: Among non-invasive techniques, 1H magnetic resonance spectroscopy (MRS) is the reference standard for the quantitative assessment of liver steatosis. However, some magnetic resonance imaging (MRI) techniques, which are more available and allow to study the whole liver parenchyma, have been recently introduced. The purpose of this study was to evaluate different MRI techniques (dual-phase and multiecho gradient-echo) in the quantitative assessment of liver steatosis, using MRS as the reference standard.
METHODS: Forty-five HIV-infected patients underwent MR examination for steatosis assessment. Liver fat content (LFC) was estimated by means of MRS and two MRI techniques: dual-phase T1-weighted gradient-echo (DP-LFC) and multiecho gradient-echo. For this last technique, LFC was calculated both on the same single voxel dualused for spectroscopy (SV-ME-LFC) and on the whole liver parenchyma with two different methods: selecting 12 elliptical regions of interest (ROI) on three different slices (12ROI-ME-LFC) and selecting three free-hand ROIs comprehending the whole liver volume on the same slices (WV-ME-LFC). The associations between LFC calculated with different techniques were measured with univariate linear regression analysis after normalization of non-normally distributed variables. Wilcoxon matched-pairs signed-ranks test corrected for multiple comparison was used to evaluate differences among LFCs calculated with the different MR techniques.
RESULTS: Strong associations were found between MRS LFC and DP-LFC (R2=0.96; P<0.001, β=1.23), SVME-LFC (R2=0.96; P<0.001, β=0.95), 12ROI-ME-LFC (R2=0.94; P<0.001, β=0.93), and WV-ME-LFC (R2=0.93; P<0.001, β=0.96). Wilcoxon matched-pairs signed-ranks test showed statistically significant differences among MRS LFC and DP-LFC (P<0.001), as well as between 12ROI-ME-LFC and DP-LFC (P=0.01).
CONCLUSIONS: MRI techniques are reliable in quantitative steatosis assessment when compared to MRS. LFC estimated with all imaging techniques was strongly associated with MRS LFC, however multiecho techniques showed more accurate results.


KEY WORDS: Non-alcoholic fatty liver disease - Congenital visceral steatosis - Fatty liver - Spectrum analysis - Magnetic resonance spectroscopy

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