Nonalcoholic Fatty Liver Disease: Rapid Evaluation of Liver Fat Content with In-Phase and Out-of-Phase MR Imaging

Borra, Ronald; Salo, S.; Dean, Kirsti I.; Lautamäki, Riikka; Nuutila, Pirjo; Komu, Markku; Parkkola, Riitta

doi:10.1148/radiol.2501071934

Cited by 99 publications

(74 citation statements)

References 39 publications

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“…In particular, in the largest study, which included 2,349 patients, the highest fat percentage was 47.5% [3]. Percentages of liver fat found in this study are in good agreement with previously published literature concerning type 2 diabetic patients, since reported LFF were in the 0-45% range with median values between 8 and 19% [14,[32][33][34].…”

Section: Discussionsupporting

confidence: 92%

Mapping of liver fat with triple-echo gradient echo imaging: validation against 3.0-T proton MR spectroscopy

Guiu¹,

Loffroy²,

Petit

et al. 2009

Eur Radiol

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The purpose of this study was to validate a magnetic resonance imaging (MRI) technique for mapping liver fat, using (1)H magnetic resonance spectroscopy ((1)H-MRS) as the reference standard. In 91 patients with type 2 diabetes, 3.0-T single-voxel point-resolved (1)H-MRS was used to calculate the liver fat fraction (LFF) from the water (4.76 ppm) and methylene (1.33 ppm) peaks, corrected for T1 and T2 decays. LFF (corrected for T1 and T2* decays) was also obtained from the mean signal intensity on a map built from a triple-echo (consecutive in-phase, opposed-phase, and in-phase echo times) breath-hold gradient echo sequence, using basic image calculation functions (arithmetic mean, subtraction, division, multiplication by a numerical factor). Mean LFF was 8.9% (range, 0.9-33.5) by MRI and 8.8% (range, 0-34.1) by (1)H-MRS. Pearson's coefficient was 0.976 (P < 0.0001) and Lin's coefficient was 0.975 (P < 0.0001). Liver segment had no significant influence. With Bland-Altman analysis, 95.6% (87/91) of data points were within the limits of agreement. Given its excellent agreement with (1)H-MRS, our mapping technique can be used for visual and quantitative evaluation of liver fat in everyday practice.

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Section: Discussionsupporting

confidence: 92%

Mapping of liver fat with triple-echo gradient echo imaging: validation against 3.0-T proton MR spectroscopy

Guiu¹,

Loffroy²,

Petit

et al. 2009

Eur Radiol

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“…Liver fat index was obtained in all cooperative subjects, and calculated as follows: (SI IP À SI OP )/SI IP (19).…”

Section: Quantitative Analysismentioning

confidence: 99%

“…One common modification of T1-weighted imaging is in-phase (IP) and out-of-phase (OP) imaging, used to detect (microscopic) fat, which signals the presence of many common diseases (16)(17)(18)(19)(20)(21)(22). At 3.0T, the shortest OP TE is 1.15 ms and the shortest IP TE is 2.3 ms.…”

mentioning

confidence: 99%

Comparison of T1‐weighted in‐ and out‐of‐phase single shot magnetization‐prepared gradient‐recalled‐echo with three‐dimensional gradient‐recalled‐echo at 3.0 tesla: Preliminary observations in abdominal studies

Ferreira¹,

Ramalho²,

Campos³

et al. 2011

Magnetic Resonance Imaging

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Purpose: To describe in-phase (IP)/out-of-phase (OP) imaging with single shot magnetization-prepared gradient-recalled-echo (MP-GRE) and to compare intra-individually IP/OP MP-GRE with IP/OP three-dimensional gradient-recalled-echo (3D-GRE) at 3.0 Tesla (T). Materials and Methods:Thirty-six subjects (15 males, 21 females; mean age 46.97 6 14.97) who had abdominal MRI examinations including precontrast T1-weighted IP/ OP MP-GRE, IP/OP 3D-GRE were included in the study. Two radiologists independently evaluated the sequences qualitatively for extent of artifacts, lesion detectability, and conspicuity and subjective grading of liver steatosis. Quantitative evaluation was performed by one radiologist and included liver fat index, liver and spleen SNR, and liver-lesion and liver-spleen CNR.Results: Respiratory ghosting was more pronounced on 3D-GRE (P < 0.0008). The degrees of parallel imaging residual artifacts, shading and blurring were significantly higher on the 3D-GRE sequences (P < 0.0008). Spatial misregistration and bounce point artifacts were only observed with MP-GRE images. Pixel graininess was more apparent on MP-GRE (P < 0.0008). Lesion detectability, confidence, and conspicuity were considerably higher on MP-GRE. Visual appreciation of steatosis was superior on 3D-GRE. Overall image quality was superior on MP-GRE (P < 0.0008). Conclusion:Higher image quality and improved lesion detectability were present with IP/OP MP-GRE technique. Inversion-recovery prepared techniques may represent an important evolution for precontrast T1-weighted image at 3.0T. The good image quality of MP-GRE sequences acquired in a free breathing manner should recommend its use in patients unable to suspend breathing.

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“…Therefore, noninvasive quantitative markers or diagnostic tests are required for assessing the presence and severity of liver cirrhosis. MR elastography, diffusionweighted MRI, and perfusion CT or MR imaging have been investigated as noninvasive quantitative imaging markers for the staging of liver cirrhosis (3)(4)(5)(6)(7).…”

mentioning

confidence: 99%

Quantitative evaluation of liver cirrhosis using T1 relaxation time with 3 tesla MRI before and after oxygen inhalation

Kim

Park

Kim³

et al. 2012

Magnetic Resonance Imaging

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Purpose: To quantify liver T1 relaxation times before and after oxygen inhalation in patients with and without liver cirrhosis using a 3 Tesla (T) MRI. Materials and Methods:Institutional Review Board approval and written informed consent were obtained. Ninety-two noncirrhotic patients and 87 patients with hepatitis B viral liver cirrhosis (72 Child-Pugh class A and 15 Child-Pugh class B or C) underwent MRI with a 3.0T system before and after the supply of 100% oxygen at a rate of 15 L/min by means of a nonrebreather ventilation mask for 3 min. T1 maps were acquired using threedimensional spoiled gradient echo sequences with two different flip angles (2 and 14 ) and a fixed TR/TE (2.54 ms/0.95 ms). Liver T1 values were obtained using a T1 processing tool (MapIT software). The mean baseline T1 values of three groups (control, Child-Pugh class A, and Child-Pugh class B/C) were compared using an analysis of variance test. Liver T1 value before and after oxygenation was compared using a paired t-test for each group.Results: The baseline liver T1 value was significantly higher in the control group (941 6 136 ms) than in ChildPugh A (858 6 143 ms) and Child-Pugh B/C (783 6 164 ms) group (P < 0.001 and P < 0.0001). The reduction in the liver T1 value after oxygen inhalation was significant in the control group (P ¼ 0.012) but not significant in Child-Pugh class A (P ¼ 0.079) and Child-Pugh class B/C (P ¼ 0.752). Conclusion:The baseline liver T1 relaxation time was significantly different between the patients with and without liver cirrhosis. The shortening effect of oxygen on the liver T1 value was significant in the control group but not in the cirrhotic patients.

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Nonalcoholic Fatty Liver Disease: Rapid Evaluation of Liver Fat Content with In-Phase and Out-of-Phase MR Imaging

Abstract: In-phase and out-of-phase imaging can be used to rapidly estimate the LFC in patients with NAFLD. The cutoff value of 5.1% enables objective rapid and reliable discrimination of normal LFC from elevated LFC.

Cited by 99 publications

References 39 publications

Mapping of liver fat with triple-echo gradient echo imaging: validation against 3.0-T proton MR spectroscopy

Mapping of liver fat with triple-echo gradient echo imaging: validation against 3.0-T proton MR spectroscopy

Comparison of T1‐weighted in‐ and out‐of‐phase single shot magnetization‐prepared gradient‐recalled‐echo with three‐dimensional gradient‐recalled‐echo at 3.0 tesla: Preliminary observations in abdominal studies

Quantitative evaluation of liver cirrhosis using T1 relaxation time with 3 tesla MRI before and after oxygen inhalation

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