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Multiparametric MR Is a Valuable Modality for Evaluating Disease Severity of Nonalcoholic Fatty Liver Disease

Because nonalcoholic fatty liver disease (NAFLD) is becoming a leading cause of chronic liver disease, noninvasive evaluations of its severity are immediately needed. This prospective cross-sectional study evaluated the effectiveness of noninvasive assessments of hepatic steatosis, fibrosis, and ste...

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Detalles Bibliográficos
Autores principales: Lee, Young-Sun, Yoo, Yang Jae, Jung, Young Kul, Kim, Ji Hoon, Seo, Yeon Seok, Yim, Hyung Joon, Kim, In Hee, Lee, Soo Yeon, Kim, Baek-Hui, Kim, Jeong Woo, Lee, Chang Hee, Yeon, Jong Eun, Kwon, So Young, Um, Soon Ho, Byun, Kwan Soo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7263657/
https://www.ncbi.nlm.nih.gov/pubmed/32251018
http://dx.doi.org/10.14309/ctg.0000000000000157
Descripción
Sumario:Because nonalcoholic fatty liver disease (NAFLD) is becoming a leading cause of chronic liver disease, noninvasive evaluations of its severity are immediately needed. This prospective cross-sectional study evaluated the effectiveness of noninvasive assessments of hepatic steatosis, fibrosis, and steatohepatitis. METHODS: Patients underwent laboratory tests, liver biopsy, transient elastography, and MRI. Multiparametric MR was used to measure MRI proton density fat fraction, MR spectroscopy, T1 mapping, and MR elastography (MRE). RESULTS: We enrolled 130 patients between October 2016 and July 2019. For the diagnosis of moderate-to-severe steatosis (grade ≥ 2), the area under the receiver operating characteristic curve (AUROC) was lower in controlled attenuation parameter (0.69; 95% confidence interval [CI], 0.60–0.76) than MRI proton density fat fraction (0.82; 95% CI, 0.75–0.89; P = 0.008) and MR spectroscopy (0.83; 95% CI, 0.75–0.89; P = 0.006). For the diagnosis of advanced fibrosis (stage ≥ 3), the AUROC of MRE (0.89; 95% CI, 0.83–0.94) was superior compared with those of the Fibrosis-4 index (0.77; 95% CI, 0.69–0.84; P = 0.010), NAFLD fibrosis score (0.81; 95% CI, 0.73–0.87; P = 0.043), and transient elastography (0.82; 95% CI, 0.74–0.88; P = 0.062). For detecting advanced fibrosis or nonalcoholic steatohepatitis, the AUROC of MRE (0.86; 95% CI, 0.79–0.91) was higher than that of TE (0.76; 95% CI, 0.68–0.83) with statistical significance (P = 0.018). DISCUSSION: Multiparametric MR accurately identified a severe form of NAFLD. Multiparametric MR can be a valuable noninvasive method for evaluating the severity of NAFLD.