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

 Han Ah Lee  ;  Seung-Seob Kim  ;  Jin-Young Choi  ;  Yeon Seok Seo  ;  Beom Jin Park  ;  Ki Choon Sim  ;  Seung Up Kim 
 ABDOMINAL RADIOLOGY, Vol.47(11) : 3733-3745, 2022-11 
Journal Title
Issue Date
Biopsy ; Elasticity Imaging Techniques* / methods ; Humans ; Liver / diagnostic imaging ; Liver / pathology ; Liver Cirrhosis / complications ; Liver Cirrhosis / diagnostic imaging ; Liver Cirrhosis / pathology ; Magnetic Resonance Imaging / methods ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease* / complications ; Non-alcoholic Fatty Liver Disease* / diagnostic imaging ; Non-alcoholic Fatty Liver Disease* / pathology ; Protons ; ROC Curve ; Retrospective Studies
Controlled attenuation parameter ; Histology ; MR elastography ; Proton density fat fraction ; Transient elastography
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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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seung-seob(김승섭) ORCID logo https://orcid.org/0000-0001-6071-306X
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Choi, Jin Young(최진영) ORCID logo https://orcid.org/0000-0002-9025-6274
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