Keywords:
Pathology, Biopsy, MR-Spectroscopy, MR, Liver, Abdomen
Authors:
A. M. Lapadat, L. M. Florescu, S. Bondari, I. A. Gheonea; Craiova/RO
DOI:
10.1594/ecr2018/C-1652
Aims and objectives
Non-alcoholic fatty liver (NAFLD) is currently considered a major public health problem worldwide,
being one of the most common causes of liver disease in the West,
affecting 20-40% of the adult population.
Obesity,
Type II diabetes mellitus and dyslipidemia,
in the absence of alcohol consumption,
are the most important risk factors for non-alcoholic fatty liver,
revealed by a series of epidemiological studies that independently showed a strong relationship between each of these factors and disease.
[1,2] Non-alcoholic fatty liver comprises several clinical entities,
starting from hepatic steatosis and reaching steatohepatitis,
fibrosis and even liver cirrhosis,
aspects requiring histological confirmation.[2] Non-Alcoholic Steatohepatitis (NASH) is a subgroup of NAFLD patients characterized by balloon degeneration,
lobular inflammation with or without peri-sinusoidal fibrosis on liver biopsy.
Patients with NASH have an increased risk of progression to cirrhosis.
[3,4] Approximately 3% of people in developed countries may have NASH; although this is an underestimation because many patients with NAFLD have no liver biopsy.
It is estimated that approximately 10% of NASH patients may develop cirrhosis and 10-20% of them may die due to complications of liver failure or may require liver transplantation.
[5,6,7] Liver biopsy is still the "gold standard" for assessing steatosis and liver fibrosis but it is an invasive method,
hard to accept by patients,
and is also a side effect.
Thus,
at the level world,
most of the modern research has been geared toward implementing some methods alternative,
non-invasive diagnosis to ensure a more accurate quantification of liver steatosis and fibrosis and which are of sufficient accuracy to allow both a precise diagnosis and to provide the possibility of monitoring the evolution of hepatopathy through repeatability and reproducibility.
[8] At present,
it is of great importance to study non-invasive diagnostic methods to identify imaging techniques that correlate with steatohepatitis and liver fibrosis and to establish clear indications of liver biopsy in patients with non-alcoholic.
[2] Ultrasound (US) and computed tomography (CT) can be used to assess liver fat but have limited accuracy.
Magnetic resonance spectroscopy (MRS) can assess qualitatively and quantitatively valuate the liver fat more directly than CT or US.
[9] The aim of this study was to validate magnetic resonance spectroscopy (MRS) performed with a 3T MRI system for quantifying hepatic steatosis.