Early Detection of Nonalcoholic Steatohepatitis in Patients with Nonalcoholic Fatty Liver Disease by Using MR Elastography
Top Cited Papers
- 1 June 2011
- journal article
- Published by Radiological Society of North America (RSNA) in Radiology
- Vol. 259 (3), 749-756
- https://doi.org/10.1148/radiol.11101942
Abstract
Purpose To investigate the diagnostic accuracy (area under the receiver operating characteristic curve [AUROC]) of magnetic resonance (MR) elastography for the early detection of nonalcoholic steatohepatitis (NASH) among patients with nonalcoholic fatty liver disease (NAFLD). Materials and Methods An institutional review board–approved and HIPAA-compliant retrospective study was conducted in 58 NAFLD patients. Informed consent was waived by the review board. Hepatic stiffness, relative fat fraction, inflammation grade, and fibrosis stage were assessed from MR elastography, in-phase and out-of-phase gradient-echo imaging, and liver biopsy histopathologic review, respectively. Pairwise t testing, receiver operating characteristic analysis, and partial correlation analysis were performed. Results The mean hepatic stiffness for patients with simple steatosis (2.51 kPa) was less (P = .028) than that for patients with inflammation but no fibrosis (3.24 kPa). The mean hepatic stiffness for patients with inflammation but no fibrosis was less (P = .030) than that for patients with hepatic fibrosis (4.16 kPa). Liver stiffness had high accuracy (AUROC = 0.93) for discriminating patients with NASH from those with simple steatosis, with a sensitivity of 94% and a specificity 73% by using a threshold of 2.74 kPa. Conclusion In patients with NAFLD, hepatic stiffness measurements with MR elastography can help identify individuals with steatohepatitis, even before the onset of fibrosis; NAFLD patients with inflammation but no fibrosis have greater liver stiffness than those with simple steatosis and lower mean stiffness than those with fibrosis. © RSNA, 2011Keywords
This publication has 62 references indexed in Scilit:
- Repeatability of magnetic resonance elastography for quantification of hepatic stiffnessJournal of Magnetic Resonance Imaging, 2010
- Cytokeratin-18 fragment levels as noninvasive biomarkers for nonalcoholic steatohepatitis: A multicenter validation studyHepatology, 2009
- Assessment of fibrosis in chronic liver diseasesJournal of Digestive Diseases, 2009
- Plasma Pentraxin3 is a Novel Marker for Nonalcoholic Steatohepatitis (NASH)BMC Gastroenterology, 2008
- Magnetic Resonance Elastography for the Noninvasive Staging of Liver FibrosisGastroenterology, 2008
- Noninvasive markers of fibrosis in nonalcoholic fatty liver disease: Validating the European Liver Fibrosis Panel and exploring simple markersHepatology, 2007
- Assessment of Hepatic Fibrosis With Magnetic Resonance ElastographyClinical Gastroenterology and Hepatology, 2007
- The NAFLD fibrosis score: A noninvasive system that identifies liver fibrosis in patients with NAFLDHepatology, 2007
- Design and validation of a histological scoring system for nonalcoholic fatty liver diseaseHepatology, 2005
- Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with chronic hepatitis CHepatology, 2004