Magnetic Resonance Elastography vs Transient Elastography in Detection of Fibrosis and Noninvasive Measurement of Steatosis in Patients With Biopsy-Proven Nonalcoholic Fatty Liver Disease
| Autor: | Mosab H. Alquiraish, Jonathan Hooker, Claude B. Sirlin, Kimberly Ramirez, David A. Brenner, Phirum Nguyen, Charlie C. Park, Lisa Richards, Rohit Loomba, Michael T. Savides, Mark A. Valasek, Lynda Fortney, Carolyn Hernandez, Ethan Z. Sy, Ricki Bettencourt, Emily Rizo |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Liver Cirrhosis
Male Pathology Magnetic Resonance Spectroscopy Biopsy Gastroenterology Hepatitis 0302 clinical medicine Non-alcoholic Fatty Liver Disease Fibrosis Nonalcoholic fatty liver disease Prospective Studies Comparative Ultrasonography medicine.diagnostic_test Liver Disease Middle Aged Magnetic Resonance Imaging Liver Liver biopsy Area Under Curve 030220 oncology & carcinogenesis Elasticity Imaging Techniques Biomedical Imaging Female 030211 gastroenterology & hepatology Adult medicine.medical_specialty Chronic Liver Disease and Cirrhosis Clinical Sciences Assessment Noninvasive Article Paediatrics and Reproductive Medicine 03 medical and health sciences Clinical Research Internal medicine medicine Humans In patient Aged Receiver operating characteristic Gastroenterology & Hepatology Hepatology business.industry Neurosciences Biomarker medicine.disease Magnetic resonance elastography Good Health and Well Being Cross-Sectional Studies ROC Curve Steatosis Digestive Diseases Transient elastography business |
| Zdroj: | Park, CC; Nguyen, P; Hernandez, C; Bettencourt, R; Ramirez, K; Fortney, L; et al.(2017). Magnetic Resonance Elastography vs Transient Elastography in Detection of Fibrosis and Noninvasive Measurement of Steatosis in Patients With Biopsy-Proven Nonalcoholic Fatty Liver Disease. GASTROENTEROLOGY, 152(3), 598-+. doi: 10.1053/j.gastro.2016.10.026. UC San Diego: Retrieved from: http://www.escholarship.org/uc/item/9kn8f943 Gastroenterology, vol 152, iss 3 |
| Popis: | Background & Aims Magnetic resonance imaging (MRI) techniques and ultrasound-based transient elastography (TE) can be used in noninvasive diagnosis of fibrosis and steatosis in patients with nonalcoholic fatty liver disease (NAFLD). We performed a prospective study to compare the performance of magnetic resonance elastography (MRE) vs TE for diagnosis of fibrosis, and MRI-based proton density fat fraction (MRI-PDFF) analysis vs TE-based controlled attenuation parameter (CAP) for diagnosis of steatosis in patients undergoing biopsy to assess NAFLD. Methods We performed a cross-sectional study of 104 consecutive adults (56.7% female) who underwent MRE, TE, and liver biopsy analysis (using the histologic scoring system for NAFLD from the Nonalcoholic Steatohepatitis Clinical Research Network Scoring System) from October 2011 through May 2016 at a tertiary medical center. All patients received a standard clinical evaluation, including collection of history, anthropometric examination, and biochemical tests. The primary outcomes were fibrosis and steatosis. Secondary outcomes included dichotomized stages of fibrosis and nonalcoholic steatohepatitis vs no nonalcoholic steatohepatitis. Receiver operating characteristic curve analyses were used to compare performances of MRE vs TE in diagnosis of fibrosis (stages 1–4 vs 0) and MRI-PDFF vs CAP for diagnosis of steatosis (grades 1–3 vs 0) with respect to findings from biopsy analysis. Results MRE detected any fibrosis (stage 1 or more) with an area under the receiver operating characteristic curve (AUROC) of 0.82 (95% confidence interval [CI], 0.74–0.91), which was significantly higher than that of TE (AUROC, 0.67; 95% CI, 0.56−0.78). MRI-PDFF detected any steatosis with an AUROC of 0.99 (95% CI, 0.98−1.00), which was significantly higher than that of CAP (AUROC, 0.85; 95% CI, 0.75−0.96). MRE detected fibrosis of stages 2, 3, or 4 with AUROC values of 0.89 (95% CI, 0.83−0.96), 0.87 (95% CI, 0.78−0.96), and 0.87 (95% CI, 0.71−1.00); TE detected fibrosis of stages 2, 3, or 4 with AUROC values of 0.86 (95% CI, 0.77−0.95), 0.80 (95% CI, 0.67–0.93), and 0.69 (95% CI, 0.45–0.94). MRI-PDFF identified steatosis of grades 2 or 3 with AUROC values of 0.90 (95% CI, 0.82−0.97) and 0.92 (95% CI, 0.84−0.99); CAP identified steatosis of grades 2 or 3 with AUROC values of 0.70 (95% CI, 0.58−0.82) and 0.73 (95% CI, 0.58−0.89). Conclusions In a prospective, cross-sectional study of more than 100 patients, we found MRE to be more accurate than TE in identification of liver fibrosis (stage 1 or more), using biopsy analysis as the standard. MRI-PDFF is more accurate than CAP in detecting all grades of steatosis in patients with NAFLD. |
| Databáze: | OpenAIRE |
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