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. 2017 Jul;11(7):TC06-TC10.
doi: 10.7860/JCDR/2017/26317.10234. Epub 2017 Jul 1.

Quantification of Liver Fat with mDIXON Magnetic Resonance Imaging, Comparison with the Computed Tomography and the Biopsy

Venkatraman Bhat  1 , Sundararaman Velandai  2 , Vikram Belliappa  3 , Jeyeram Illayraja  4 , Karthik Gadabana Halli  5 , Gayathri Gopalakrishnan  6
Affiliations

Quantification of Liver Fat with mDIXON Magnetic Resonance Imaging, Comparison with the Computed Tomography and the Biopsy

Venkatraman Bhat et al. J Clin Diagn Res. 2017 Jul.

Abstract

Introduction: Accurate, non-invasive method of fat estimation is a valuable test for evaluation of diseases with abnormal hepatic fat.

Aim: To determine the accuracy of mDixon MR technique in assessment of liver fat over CT and to correlate the CT and MRI findings with biopsy.

Materials and methods: A prospective observational study was conducted at Imaging Services of Narayana Multispeciality Hospital between March 2011- December 2012. Thirty patients who attended the clinic for non-hepatic complaints were included in the study. Patients with known liver disease, cirrhosis, alcoholic liver disease, bleeding diathesis and claustrophobic patients were excluded from the study. Subjects underwent sonography, CT liver and MR examination of liver for fat estimation using mDixon protocol. Biopsy of the liver was performed either by image guidance or by direct biopsy. Liver Attenuation Index (LAI), fat estimation by MR methods were reviewed independently by two observers and compared with biopsy results. The statistical analysis was performed by SPSS. Pearson correlation was used to find the correlation between the left and right lobe of liver segments by CT and histological correlation.

Results: There was good correlation between the MR estimation of liver fat and histological grading. Majority (90%) of patients had fat content of less than 10%. Maximal fat content of 28% was observed in one patient. LAI values poorly correlated with the MRI and histological observations.

Conclusion: MR estimation of the liver using mDixon technique yielded specific information about liver fat, correlated well with the histological grading. Technique is more accurate than CT, does not involve ionising radiation, hence recommended as method of choice.

Keywords: Hepatic fat estimation; Hepatic steatosis; Liver CT; Liver biopsy; mDixon MRI.

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Figures

[Table/Fig-2]:
[Table/Fig-2]:
a) Axial MRI (mDIXON) and CT section of the liver showing location of region of interest (ROI 1,2) in right and left lobes and mesentery (ROI 3). MR images provide direct measurement of fat percentage. CT LAI index is mean of averaged multiple values. A table of MR, CT values and histology in patient with high fat (<66%) is shown; b) Grey scale and colour coded fat maps in a patient with 4% liver fat.
[Table/Fig-5]:
[Table/Fig-5]:
Graph showing inter-observer agreement in MR readings for assessment of both lobes.
See this image and copyright information in PMC

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