Normal Range of Hepatic Fat Fraction on Dual- and Triple-Echo Fat Quantification MR in Children

Shin, Hyun Joo; Kim, Hyun Gi; Kim, Myung Joon; Koh, Hong; Kim, Ha Yan; Roh, Yun Ho; Lee, Mi Jung

doi:10.1371/journal.pone.0117480

Cited by 16 publications

(18 citation statements)

References 29 publications

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“…Occasionally, fat-/water swaps occurred, especially in the liver dome (segment VII/VIII), but no ROIs were drawn in these regions for the purpose of the current study. We used a dual-echo sequence for fat quantification which is prone to potentially confounding T1 and T2* relaxation effects [ 38 , 39 ], but a recent paper [ 40 ] showed no difference in dual fat fraction and triple fat fraction in healthy children with a mean value of 2.3±2.0% on dual-echo MRI and 2.9±1.4% on triple-echo MRI. Dual-echo imaging was shown to measure lower FSF values in patients with pathological liver iron deposition [ 41 ], an effect, which in part may be corrected with multi-echo imaging [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Age- and Gender Dependent Liver Fat Content in a Healthy Normal BMI Population as Quantified by Fat-Water Separating DIXON MR Imaging

et al. 2015

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ObjectivesTo establish age- and sex-dependent values of magnetic resonance (MR) liver fat-signal fraction (FSF) in healthy volunteers with normal body-mass index (BMI).Methods2-point mDIXON sequences (repetition time/echo time, 4.2msec/1.2msec, 3.1msec) at 3.0 Tesla MR were acquired in 80 healthy volunteers with normal BMI (18.2 to 25.7 kg/m2) between 20 and 62 years (10 men/10 women per decade). FSF was measured in 5 liver segments (segment II, III, VI, VII, VIII) based on mean signal intensities in regions of interest placed on mDIXON-based water and fat images. Multivariate general linear models were used to test for significant differences between BMI-corrected FSF among age subgroups. Pearson and Spearman correlations between FSF and several body measures were calculated.ResultsMean FSF (%) ± standard deviations significantly differed between women (3.91 ± 1.10) and men (4.69 ± 1.38) and varied with age for women/men (p-value: 0.002/0.027): 3.05 ± 0.49/3.74 ± 0.60 (age group 20–29), 3.75 ± 0.66/4.99 ± 1.30 (30–39), 4.76 ± 1.16/5.25 ± 1.97 (40–49) and 4.09 ± 1.26/4.79 ± 0.93 (50–62). FSF differences among age subgroups were significant for women only (p = 0.003).ConclusionsMR-based liver fat content is higher in men and peaks in the fifth decade for both genders.

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Section: Discussionmentioning

confidence: 99%

Age- and Gender Dependent Liver Fat Content in a Healthy Normal BMI Population as Quantified by Fat-Water Separating DIXON MR Imaging

et al. 2015

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“…Subjects were divided into three groups. One was the normal group, for those who had normal MR proton density fat fraction (PDFF) of the liver (< 6% according to a previous study)[ 13 ], normal body mass index, and normal transient elastography (TE) results when they had TE results within one year of MRI examinations. The second was the fatty liver (FAT) group, for subjects who had PDFF greater than 6%.…”

Section: Methodsmentioning

confidence: 99%

Liver intravoxel incoherent motion diffusion-weighted imaging for the assessment of hepatic steatosis and fibrosis in children

Shin¹,

Yoon²,

Kim³

et al. 2018

WJG

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AIMTo evaluate the correlation between intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) parameters and the degree of hepatic steatosis and fibrosis in children.METHODSThis retrospective study was approved by the institutional review board. The children (≤ 18 years) who underwent liver IVIM DWI with 8 b-values under the suspicion of hepatic steatosis or fibrosis from February 2013 to November 2016 were included. Subjects were divided into normal, fatty liver (FAT), and fibrotic liver (FIB) groups. The slow diffusion coefficient (D), fast diffusion coefficient (D*), perfusion fraction (f), and apparent diffusion coefficient (ADC) were measured. MR proton density fat fraction (PDFF), MR elastography (MRE), and IVIM values were compared.RESULTSA total of 123 children (median age of 12 years old, range: 6-18 years) were included, with 8 in the normal group, 93 in the FAT group, and 22 in the FIB group. The D* values were lower in the FIB group compared with those of the normal (P = 0.015) and FAT (P = 0.003) groups. The f values were lower in the FIB group compared with the FAT group (P = 0.001). In multivariate analyses, PDFF value was positively correlated with f value (β = 3.194, P < 0.001), and MRE value was negatively correlated with D* value (β = -7.031, P = 0.032). The D and ADC values were not influenced by PDFF or MRE value.CONCLUSIONIn liver IVIM DWI with multiple b-values in children, there was a positive correlation between hepatic fat and blood volume, and a negative correlation between hepatic stiffness and endovascular blood flow velocity, while diffusion-related parameters were not affected.

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“…The complexity tends to increase considering a wider age-range. Accordingly, it has been found that in non-obese children the median fat fraction was 1.6%-2.7% up to a maximum of 6.5–8.0% dependent on whether measured using dual or triple echo gradient-recalled echo sequence MRI11. Another study performed on obese children without NAFLD found a mean hepatic fat fraction of 2.0% up to a maximum of 4.69%12.…”

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Transaminase abnormalities and adaptations of the liver lobule manifest at specific cut-offs of steatosis

Hall

Covelli

Manuguerra

et al. 2017

Sci Rep

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There is little documented evidence suggesting that liver fat is responsible for liver injury in the absence of other disease processes. We investigated the relationships between liver fat, aminotransferases and hepatic architecture in liver biopsies with simple steatosis. We identified 136 biopsies with simple steatosis from the Royal Free Hospital Archives with both clinical data and sufficient material. Digital image analysis was employed to measure fat proportionate area (mFPA). Hepatocyte area (HA) and lobule radius (LR) were also measured. There were significant increases in ALT (p < 0.001) and AST (p = 0.013) with increased fat content and evidence to suggest both 5% and 20% mFPA as a cut-off for raised ALT. In liver with increased fat content there were significant increases in HA (p < 0.001). LR also increased as mFPA increased to 10% (p < 0.001), at which point the lobule ceased to expand further and was counterbalanced with a decrease in the number of hepatocytes per lobule (p = 0.029). Consequently there are mechanisms of adaption in the liver architecture to accommodate the accumulation of fat and these are accompanied by significant increases in transaminases. These results support the generally accepted cut-off of 5% fat for steatosis and indicate 20% as a threshold of more severe liver injury.

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Normal Range of Hepatic Fat Fraction on Dual- and Triple-Echo Fat Quantification MR in Children

Cited by 16 publications

References 29 publications

Age- and Gender Dependent Liver Fat Content in a Healthy Normal BMI Population as Quantified by Fat-Water Separating DIXON MR Imaging

Age- and Gender Dependent Liver Fat Content in a Healthy Normal BMI Population as Quantified by Fat-Water Separating DIXON MR Imaging

Liver intravoxel incoherent motion diffusion-weighted imaging for the assessment of hepatic steatosis and fibrosis in children

Transaminase abnormalities and adaptations of the liver lobule manifest at specific cut-offs of steatosis

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