Purpose
The aim of this study was to assess in type-2 diabetic patients the heterogeneity of liver in the hepatic lobes andsegments using the triple-echo MR technique.
Methods and Materials
121 consecutive type-2 diabetic (T2D) patients were enrolled between October 2009 and September 2011.
The inclusion criteria were the following : age older than 18 yrs,
body weight less than 150kg (the MRI-table weight limit),
no known acute or chronic liver disease.
MR imaging was performed using a 3.0T unit with a peak gradient amplitude of 45 mT/m and a time-to-peak of 204 µs.
A six-element body phase-array coil was used.
The reference standard was 3.0 T H1-MR spectroscopy.
Hepatic steatosis was defined as liver...
Results
We confirm an excellent agreement between H1-MRS and triple-echo technique (Pearson's correlation cefficient : 0.973 (P<0.0001).
Fifty-nine (48.8%) patients had liver steatosis while 62 (51.2%) did not.
The right liver had a greater degree of steatosis than the left (P<0.0001) ( mean difference : 1.32% [range 0.01-8.75%]),
in both steatotic and non-steatotic livers,
the difference was also significant (P<0.0001) (Fig2).
In 7 patients (5.8%),
LFC was < 5.56% in one liver whereas it was≥ 5.56% in the other one.
Steatosis of the left and right...
Conclusion
The deposition of liver steatosis within the liver exhibits substantial heterogeneity at a macroscopic level.
The heterogeneity is segmental and lobar.
Overall,
the mean segmental/lobar variability of steatosis is low at a patient level.
However,
segmental variability can sometimes lead to a misdiagnosis of steatosis or a substantial under or overestimationof LFC if the method used for quantification is performed in only one segment.
This potential pitfall underlines the need for methods that allow the quantification of steatosis over a large region.
References
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Hepatology 40:1387-1395.
2 Kleiner DE,
Brunt EM,
Van Natta M,
et al.
(2005) Design and validation of a histological scoring system for nonalcoholic fatty liver disease.
Hepatology 41:1313-1321.
3 Merriman RB,
Ferrell LD,
Patti MG,
et al.
(2006) Correlation of paired liver biopsies in morbidly obese patients with suspected nonalcoholic fatty liver disease.
Hepatology 44:874-880.
4 Ratziu V,
Charlotte F,...
Personal Information
Violaine CAPITAN
[email protected]
Department of diagnostic and interventional Radiology
CHU (university hospital) le Bocage
14 rue Paul Gaffarel
21000 DIJON