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Magnetic resonance imaging improves stratification of fibrosis and steatosis in patients with chronic liver disease

Authors
Lee, Han AhKim, Seung-seobChoi, Jin-YoungSeo, Yeon SeokPark, Beom JinSim, Ki ChoonKim, Seung Up
Issue Date
Nov-2022
Publisher
Springer New York
Keywords
MR elastography; Proton density fat fraction; Transient elastography; Controlled attenuation parameter; Histology
Citation
Abdominal Radiology, v.47, no.11, pp.3733 - 3745
Indexed
SCIE
SCOPUS
Journal Title
Abdominal Radiology
Volume
47
Number
11
Start Page
3733
End Page
3745
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/61375
DOI
10.1007/s00261-022-03618-x
ISSN
2366-004X
Abstract
Purpose We aimed to compare the diagnostic accuracy of magnetic resonance imaging (MRI) and transient elastography (TE) in assessing liver fibrosis and steatosis in patients with chronic liver disease (CLD). Methods Patients who underwent liver biopsy or liver surgery at two academic hospitals between 2017 and 2021 were retrospectively recruited. The stages of liver fibrosis and steatosis were evaluated using histologic examination. Liver stiffness (LS) was assessed using MR elastography (LSMRE) and TE (LSTE). Liver steatosis was assessed using proton density fat fraction (PDFF) and controlled attenuation parameter (CAP). Results The mean age of the study population (n = 280) was 53.6 years and male sex predominated (n = 199, 71.1%). Nonalcoholic fatty liver disease was the most prevalent (n = 127, 45.5%), followed by hepatitis B virus (n = 112, 40.0%). Hepatocellular carcinoma was identified in 130 patients (46.4%). The proportions of F0, F1, F2, F3, and F4 fibrosis were 13.2%, 31.1%, 9.6%, 16.4%, and 29.7%, respectively. LSMRE had a significantly greater AUROC value than LSTE for detecting F2–F4 (0.846 vs. 0.781, P = 0.046), whereas LSMRE and LSTE similarly predicted F1–4, F3–4, and F4 (all P > 0.05). The proportions of S0, S1, S2, and S3 steatosis were 34.7%, 49.6%, 12.5%, and 3.2%, respectively. PDFF had significantly greater AUROC values than CAP in predicting S1-3 (0.922 vs. 0.806, P < 0.001) and S2-3 (0.924 vs. 0.795, P = 0.005); however, PDFF and CAP similarly predicted S3 (P = 0.086). Conclusion MRI exhibited significantly higher diagnostic accuracy than TE for detecting significant fibrosis and mild or moderate steatosis in patients with CLD.
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Park, Beom jin
Anam Hospital (Department of Radiology, Anam Hospital)
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