Hydrogen-1 MR Spectroscopy for Measurement and Diagnosis of Hepatic Steatosis

Abstract

OBJECTIVE Hydrogen-1 MR spectroscopy (1H-MRS) is gaining acceptance as a noninvasive technique for assessment of hepatic steatosis, and the findings have been found to correlate closely with histopathologic grade. The aims of this study were to validate 1H-MRS performed with a 3-T MRI system for quantifying hepatic steatosis and to determine threshold values of 1H-MRS proton density fat fraction corresponding to standard histopathologic grade in patients undergoing diagnostic liver biopsy. SUBJECTS AND METHODS We conducted a prospective cross-sectional liver MRS study with 52 subjects undergoing diagnostic liver biopsy. The diagnostic accuracy of 1HMRS was evaluated with receiver operating characteristic curves. RESULTS The diagnostic accuracy of 1H-MRS for hepatic steatosis was high with an area under the receiver operating characteristic curve of 0.94 (95% CI, 0.88–1.0). Results were similar for three 1H-MRS measurements obtained at different locations in the liver, for two independent pathologists, and whether fibrosis was present or absent. One third of participants had elevated transaminase concentrations of unknown cause, and 1H-MRS estimates of steatosis had perfect agreement with histopathologic grade in this group. Calculated 1H-MRS proton density fat fraction thresholds for histologic grades were less than 17% for grade 0 or trace steatosis, 17–38.6% for grade 1, and greater than 38.6% for grade 2 or higher. CONCLUSION Hydrogen-1 MR spectroscopy is an effective, noninvasive technique that can be used to diagnose and quantify hepatic steatosis. Hydrogen-1 MR spectroscopy thresholds corresponded with histopathologic grades and may be useful in the workup of patients with elevated transaminase concentrations.

Effect of Tesamorelin on Visceral Fat and Liver Fat in HIV-Infected Patients With Abdominal Fat Accumulation

“…With regard to reproducibility, Bland-Altman analysis of scans repeated using our technique shows a mean difference between same-day scans of 0.29% (95% CI: −1.46 and 2.05%) 14 . The diagnostic accuracy of MRS for liver steatosis is high with an area under the receiver operating characteristic curve of 0.94 (95% CI 0.88–1.0) compared to assessment of liver biopsy by an experienced pathologist 17 . For measurement of VAT and SAT, single-slice CT has an estimated correlation between repeat measurements of 0.99, with errors in precision estimated at 1.9% for SAT and 3.9% for VAT 18 .…”

Nutritional Evaluation and Optimisation in Neonates (NEON) trial of amino acid regimen and intravenous lipid composition in preterm parenteral nutrition: a randomised double-blind controlled trial

“…58 IHCL content measured with MRS in adults has been shown to have good diagnostic accuracy and compares favourably with the gold standard of liver biopsy for the quantitative measurement of hepatic steatosis. 59 SMOFlipid has been shown to be liver protective in the context of intestinal failure and PN in children and adults. Increasingly, the use of SMOFlipid has been adopted for use in neonates with liver impairment.…”

Comparison of ultrasonography and dual echo magnetic resonance imaging in the diagnosis of fatty liver disease

“…Ayrıca bu çalışma göstermiştir ki, US ile MR arasındaki bu uyum yağlanma yokluğunda da yüksektir. Bizim çalışmamızda MRG sinyal şiddeti ile ölçülen doku yağ oranı için kullandığımız eşik değer %5.1 olup değişik çalışmalarda %5, %5.1, %5.56, %8, %17 gibi farklı eşik değerler biyopsi ve MRS ile karşılaştırılmış ve iyi korelasyon göstermiştir [9,13,18,19]. Yine de yağlanmanın MR derecesi ile US derecesi arasında birebir denklik olmaması beklenti dahilindedir.…”