医学
脂肪变性
钆酸
非酒精性脂肪肝
脂肪性肝炎
纤维化
磁共振成像
内科学
脂肪肝
胃肠病学
病理
放射科
疾病
钆DTPA
作者
Nina Bastati,Diana Feier,Andreas G. Wibmer,Stefan Traussnigg,Csilla Balássy,Dietmar Tamandl,Henrik Einspieler,Friedrich Wrba,Michael Trauner,Christian Herold,Ahmed Ba‐Ssalamah
出处
期刊:Radiology
[Radiological Society of North America]
日期:2014-02-27
卷期号:271 (3): 739-747
被引量:84
标识
DOI:10.1148/radiol.14131890
摘要
Purpose To determine whether gadoxetic acid–enhanced magnetic resonance (MR) imaging can be used to distinguish between simple steatosis and nonalcoholic steatohepatitis (NASH) in patients with nonalcoholic fatty liver disease (NAFLD), defined according to the steatosis activity and fibrosis (SAF) scoring system, which is based on the semiquantitative scoring of steatosis activity and liver fibrosis. Materials and Methods The local institutional review committee approved this study and waived written informed consent. This was a retrospective study of gadoxetic acid–enhanced 3-T MR imaging performed in 81 patients with NAFLD (45 men [56%]; mean age, 56 years; range, 25–78 years). The MR images were analyzed by using the relative enhancement (the ratio of signal intensities of the liver parenchyma before and 20 minutes after intravenous administration of gadoxetic acid). Univariate and multiple regression analyses were applied to identify variables associated with relative enhancement measurements. The ability of relative enhancement to allow differentiation between simple steatosis and NASH was assessed by using area under the receiver operating characteristic (ROC) curve analysis. Results Relative enhancement negatively correlated with the degree of lobular inflammation (r = −0.59, P < .0001), ballooning (r = −0.44, P < .0001), and fibrosis (r = −0.59, P ≤ .0001), but not with steatosis (r = −0.16, P = .15). Patients with NASH had a significantly lower relative liver enhancement (0.82 ± 0.22) than those with simple steatosis (1.39 ± 0.52) (P < .001). Relative enhancement measurements performed well in the differentiation between simple steatosis and NASH, with an area under the ROC curve of 0.85 (95% confidence interval: 0.75, 0.91) (cutoff = 1.24, sensitivity = 97%, specificity = 63%). Conclusion Gadoxetic acid relative enhancement was significantly lower in patients with NASH than in patients with simple steatosis, but further prospective studies are warranted. © RSNA, 2014
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