Clinical

Dual gradient echo MRI most accurate imaging for hepatic steatosis

Last Updated: 2010-02-17 16:04:04 -0400 (Reuters Health)

By Will Boggs, MD

NEW YORK (Reuters Health) - Dual gradient echo magnetic resonance imaging (DGE-MRI) is the most accurate means for noninvasive assessment of hepatic steatosis, according to Korean researchers.

"One of the typical clinical settings where imaging exams are requested is mildly elevated hepatic enzymes without apparent causes," coauthor Dr. Seong Ho Park from University of Ulsan College of Medicine, Seoul, told Reuters Health by email.

In a paper published online February 2nd in the Journal of Hepatology, Dr. Park and colleagues compare the accuracy of computed tomography (CT), DGE-MRI, proton magnetic resonance spectroscopy (MRS), and ultrasonography for diagnosis and quantitative estimation of hepatic steatosis.

The 161 study participants - all potential living liver donors - each had all the tests in one day, along with a liver biopsy. The researchers point out that potential living donors tend to be young, healthy, and relatively lean.

Sixty participants (37.3%) had hepatic steatosis of at least 5%, including 11 with hepatic steatosis of at least 30%.

Forty-eight subjects with hepatic steatosis of at least 5% had non-alcoholic fatty liver disease, and one of these 48 had non-alcoholic steatohepatitis (NASH).

DGE-MRI and MRS generally outperformed CT and ultrasonography for diagnosing steatosis of at least 5%, and DGE-MRI tended toward a higher sensitivity for steatosis of at least 30%.

The imaging methods had similar specificities for hepatic steatosis of at least 5%. For steatosis of at least 30%, all methods except MRS were at least 90% specific.

DGE-MRI was the most accurate for quantitative estimates of steatosis, the investigators say.

Based on these findings, the researchers conclude, "DGE-MRI may be the preferred imaging examination for the noninvasive assessment of hepatic steatosis."

Dr. Park pointed out, however, that there is no noninvasive way to distinguish the progressive form of hepatic steatosis (NASH) from simple hepatic steatosis.

Also, Dr. Park said, "We still do not know clearly the risk factors for hepatic steatosis and, in particular, those for NASH. How to manage hepatic steatosis is another issue that has yet to be determined."

J Hepatol 2010.