Epidemiology of Hepatic Steatosis at a Tertiary Care Center: An MRI-based Analysis.

Autor:	Fraum TJ; Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus Box 8131, Saint Louis, MO 63110. Electronic address: tylerjfraum@wustl.edu., Ludwig DR; Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus Box 8131, Saint Louis, MO 63110., Kilian S; Southern Illinois University School of Medicine, Springfield, Illinois., Curtis WA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus Box 8131, Saint Louis, MO 63110., Pilgram TK; Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus Box 8131, Saint Louis, MO 63110., Sirlin CB; Liver Imaging Group, Department of Radiology, San Diego School of Medicine, University of California, La Jolla, California., Fowler KJ; Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus Box 8131, Saint Louis, MO 63110.
Jazyk:	angličtina
Zdroj:	Academic radiology [Acad Radiol] 2018 Mar; Vol. 25 (3), pp. 317-327. Date of Electronic Publication: 2017 Dec 02.
DOI:	10.1016/j.acra.2017.10.002
Abstrakt:	Rationale and Objectives: Little is known about the frequency and risk factors of hepatic steatosis in the tertiary care setting. Such knowledge is essential to clinicians making decisions about testing for this condition. Thus, our aim was to describe the epidemiology of hepatic steatosis, as captured by magnetic resonance imaging (MRI), at a tertiary care center. Materials and Methods: A near-consecutive cohort of 1006 adult patients underwent standard-of-care liver MRIs. Images were retrospectively processed to derive proton density fat fraction (PDFF) maps. Data from three spatially distinct regions of interest (ROIs) were aggregated to derive overall hepatic PDFF values. Demographic, anthropometric, clinical, and laboratory variables were included in a multivariate analysis to determine predictors of hepatic steatosis grades (based on established PDFF cutoffs). Hepatic steatosis grades derived from single vs aggregated ROIs were compared. Results: Hepatic steatosis was observed in 25% of patients (19% grade 1; 3% grade 2; 3% grade 3). Controlling for all other variables, the odds of hepatic steatosis increased by 7%-9% (P <.001) for each whole point increase in body mass index (BMI), whereas elevated serum bilirubin was associated with lower odds of hepatic steatosis (P = .002). Race, diabetes mellitus, dyslipidemia, and metabolic syndrome were not independently predictive of hepatic steatosis when controlling for other variables (eg, BMI). Employing single ROIs (rather than three aggregated ROIs) resulted in incorrect steatosis grading in up to 8.0% of patients. Conclusion: Many adult patients undergoing liver MRI at a tertiary care center have hepatic steatosis, with larger BMIs as the only independent predictor of higher grades. This information can be used by clinicians at such centers to make evidence-based decisions about when to test for hepatic steatosis in their patients. (Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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