scholarly journals Diagnostic Value of MRI Proton Density Fat Fraction for Assessing Liver Steatosis in Chronic Viral C Hepatitis

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Francesco Paparo ◽  
Giovanni Cenderello ◽  
Matteo Revelli ◽  
Lorenzo Bacigalupo ◽  
Mariangela Rutigliani ◽  
...  
Keyword(s):  
Liver Biopsy ◽  
Diagnostic Accuracy ◽  
Hepatic Steatosis ◽  
Transient Elastography ◽  
Liver Steatosis ◽  
Liver Stiffness ◽  
Diagnostic Value ◽  
Proton Density ◽  
Time Interval ◽  
Fat Fraction

Objective.To assess the diagnostic performance of a T1-independent, T2*-corrected multiecho magnetic resonance imaging (MRI) technique for the quantification of hepatic steatosis in a cohort of patients affected by chronic viral C hepatitis, using liver biopsy as gold standard.Methods.Eighty-one untreated patients with chronic viral C hepatitis were prospectively enrolled. All included patients underwent MRI, transient elastography, and liver biopsy within a time interval <10 days.Results.Our cohort of 77 patients included 43/77 (55.8%) males and 34/77 (44.2%) females with a mean age of 51.31 ± 11.27 (18–81) years. The median MRI PDFF showed a strong correlation with the histological fat fraction (FF) (r=0.754, 95% CI 0.637 to 0.836,P<0.0001), and the correlation was influenced by neither the liver stiffness nor the T2*decay. The median MRI PDFF result was significantly lower in the F4 subgroup (P<0.05). The diagnostic accuracy of MRI PDFF evaluated by AUC-ROC analysis was 0.926 (95% CI 0.843 to 0.973) forS≥1and 0.929 (95% CI 0.847 to 0.975) forS=2.Conclusions.Our MRI technique of PDFF estimation allowed discriminating with a good diagnostic accuracy between different grades of hepatic steatosis.

Hepatic Steatosis: Quantification by Proton Density Fat Fraction with MR Imaging versus Liver Biopsy

Radiology ◽  
2013 ◽  
Vol 267 (3) ◽  
pp. 767-775 ◽  
Author(s):  
Ilkay S. Idilman ◽  
Hatice Aniktar ◽  
Ramazan Idilman ◽  
Gokhan Kabacam ◽  
Berna Savas ◽  
...  
Keyword(s):  
Liver Biopsy ◽  
Mr Imaging ◽  
Hepatic Steatosis ◽  
Proton Density ◽  
Proton Density Fat Fraction ◽  
Fat Fraction

Transient elastography in HIV infected patients with liver steatosis identifies a high risk group for non-alcoholic steatohepatitis

2021 ◽  
Vol 19 ◽  
Author(s):  
Marina Ferri Pezzini ◽  
Hugo Cheinquer ◽  
Alexandre de Araujo ◽  
Carlos T. Schmidt-Cerski ◽  
Eduardo Sprinz ◽  
...  
Keyword(s):  
High Risk ◽  
Liver Biopsy ◽  
Transient Elastography ◽  
Liver Steatosis ◽  
Liver Stiffness ◽  
High Risk Group ◽  
Hiv Viral Load ◽  
Significant Fibrosis ◽  
Male Sex

Objective: To assess the role of TE in HIV infected patients with NAFLD. Methods: HIV infected patients undergoing ART were enrolled between August2016 and February2017. Inclusion criteria: ≥18 years with undetectable HIV viral load. Exclusion criteria: pregnancy; alcohol intake ≥20g/day and co-infection with hepatitis B or C. Patients underwent abdominal US to diagnose liver steatosis. Significant fibrosis (≥F2) was considered when APRI>1.0, FIB4>3 and liver stiffness ≥7.1kPa. Subjects with TE ≥7.1kPa were proposed a liver biopsy and the NAFLD Scoring System ≥3 was considered as diagnosis of NASH. Poisson regression model was used to identify factors associated with liver steatosis. Results: 98 patients were included. Mean age was 49±11 years and 53 (54.1%) were male. Liver steatosis was diagnosed in 31 patients (31.6%) and was independently associated with male sex (PR= 2.18) and higher BMI (PR=1.08). Among the 31 patients with NAFLD, 26 had results for TE, APRI and FIB4. The prevalence of significant fibrosis assessed by TE, APRI and FIB4 was 26.9%, 6.4% and 3.2%, respectively. Seven patients (26.9%) had a TE result ≥7.1kPa, which was associated with higher triglyceride levels, FIB4 score and CAP values. Six of those with TE ≥7.1kPa performed a liver biopsy and NASH was found in 5 (83.3%) and liver fibrosis without NASH in one. Conclusions: NAFLD prevalence in HIV infected patients is higher than general population. TE ≥7.1kPa was not able to diagnose significant fibrosis, but accurately detect a subgroup of patients with high risk for NASH among HIV monoinfected individuals with steatosis.

scholarly journals Correlation of Hepatic Steatosis with Hepatic Fibrosis in NAFLD Patients by Fibroscan

2020 ◽  
Vol 9 (3) ◽  
pp. 1-7
Author(s):  
Rishabh Sehgal ◽  
Jyotisterna Mittal ◽  
Inderpal Singh
Keyword(s):  
Hepatic Steatosis ◽  
Hepatic Fibrosis ◽  
Transient Elastography ◽  
Liver Steatosis ◽  
Liver Stiffness ◽  
Controlled Attenuation Parameter ◽  
Nonalcoholic Fatty Liver ◽  
Attenuation Parameter ◽  
History Of ◽  
The Mean

Introduction: Nonalcoholic fatty liver disease (NAFLD) is a significant cause of liver injury in the world. Transient elastography with controlled attenuation parameter (CAP) is now days commonly used as a non-invasive modality to quantify liver steatosis and stage of Fibrosis in the Liver. This study was done to the correlation of hepatic Steatosis with hepatic Fibrosis in NAFLD Patients by fibroscan. Subjects and Methods: All NAFLD patients coming to DMCH from 1/1/18 to 30/11/18 were retrospectively analysed for the presence of any correlation between Steatosis and Fibrosis using a controlled attenuation parameter (CAP) and liver stiffness measurement (kPa), respectively by Fibroscan. Patients with a history of significant alcohol intake, viral infection, severe weight loss, on TPN, on drugs like amiodarone, diltiazem, steroids were excluded. Along with this history of hypertension, diabetes and smoking were noted from the available data. Results: The mean CAP of all 446 patients was 310.58  53.55 and the mean kPa was 7.14   4.75. Overall there was a significant correlation between CAP and kPa in all NAFLD patients (p <0.000). This was also true in patients who were more than 20 years of age, who have increased levels of triglycerides and were obese. Patients with S0 steatosis had a mean kPa value of 5.33 and as the steatosis stage worsened to S3 mean kPa value also increased to a maximum of 7.63. Conclusion: Quantification of Steatosis by CAP has a significant correlation with the stage of Fibrosis, especially in patients with increasing age, obese and who have high triglyceride levels.

scholarly journals Steatosis grading consistency between controlled attenuation parameter and MRI-PDFF in monitoring metabolic associated fatty liver disease

2021 ◽  
Vol 12 ◽  
pp. 204062232110331
Author(s):  
Cong xiang Shao ◽  
Junzhao Ye ◽  
Zhi Dong ◽  
Fuxi Li ◽  
Yansong Lin ◽  
...  
Keyword(s):  
Liver Biopsy ◽  
Diagnostic Accuracy ◽  
Controlled Trial ◽  
Characteristic Curve ◽  
Proton Density ◽  
Controlled Attenuation Parameter ◽  
Attenuation Parameter ◽  
Before And After ◽  
Fat Fraction

Background: The consistency in steatosis grading between magnetic resonance imaging-based proton density fat fraction (MRI-PDFF) and controlled attenuation parameter (CAP) before and after treatment remains unclear. This study aimed to compare the diagnostic accuracy of steatosis grading between MRI-PDFF and CAP using liver biopsy as standard and to evaluate the value of monitoring changes in steatosis grading with CAP during follow-up utilizing MRI-PDFF as a reference. Methods: Consecutive patients from a biopsy cohort and a randomized controlled trial were included in this study and classified into 3 groups (the biopsy, orlistat treatment, and routine treatment subgroups). Hepatic steatosis was measured via MRI-PDFF and CAP at baseline and at the 6th month; the accuracy and cutoffs were assessed in the liver biopsy cohort at baseline. Results: A total of 209 consecutive patients were enrolled. MRI-PDFF and CAP showed comparable diagnostic accuracy for detecting pathological steatosis [⩾S1, area under the receiver operating characteristic curve (AUC) = 0.984 and 0.972, respectively]; in contrast, CAP presented significantly lower AUCs in grades S2–3 and S3 (0.820 and 0.815, respectively). The CAP values correlated well with the MRI-PDFF values at baseline and at the 6th month ( r = 0.809 and 0.762, respectively, both p < 0.001), whereas a moderate correlation in their changes ( r = 0.612 and 0.524 for moderate-severe and mild steatosis, respectively; both p < 0.001) was observed. The AUC of CAP change was obtained to predict MRI-PDFF changes of ⩾5% and ⩾10% (0.685 and 0.704, p < 0.001 and p = 0.001, respectively). The diagnostic agreement of steatosis grade changes between MRI-PDFF and CAP was weak (κ = 0.181, p = 0.001). Conclusions: CAP has decreased value for the initial screening of moderate-severe steatosis and is limited in monitoring changes in steatosis during treatment. The confirmation of steatosis grading with MRI-PDFF remains necessary.

scholarly journals Clinical relevance of lipid panel and transaminases according liver steatosis and fibrosis measured by transient elastography (Fibroscan®)

2020 ◽  
Author(s):  
Julio César Riegos
Keyword(s):  
Liver Disease ◽  
Total Cholesterol ◽  
Multiple Regression ◽  
Hepatic Steatosis ◽  
Hepatic Fibrosis ◽  
Transient Elastography ◽  
Liver Steatosis ◽  
Liver Stiffness ◽  
The Metabolic Syndrome ◽  
Lipid Panel

Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most frequent causes of chronic liver disease and it is related with co-morbilities as the metabolic syndrome. Transient elastography (Fibroscan®) is a non-invasive method to detect NAFLD using the controlled attenuation parameter (CAP). Methods. Patients with NAFLD were included. Hepatic steatosis was quantified by CAP (dB/m) and liver stiffness by Kilopascals (kPa), and were correlated with lipid profile and aspartate transaminase (AST) and alanine transaminase (ALT) transamase. In the statistical analysis, correlation and multiple regression were used. Mann-Whitney U test was used as non-parametric analysis for comparison of medians Results: One hundred five patients were included. In the multiple regression analysis, we observed an association between hepatic steatosis and total cholesterol (B = 0.021, p = 0.038, Exp (B) = 1.021, I.C = 1.001–1.041) and triglycerides (B = 0.017, p = 0.006, Exp (B) = 1.018 and I.C = 1.005–1.030). In the same way, an association between significant hepatic fibrosis and concentrations of total cholesterol (B = -0.019, p = 0.005, Exp (B) = 0.982 I.C = 0.969–0.995) and AST (B = 0.042, p = 3.25 x 10-4, Exp (B) = 1.043 I.C = 1.019–1.068) independently of age, gender, BMI. Conclusions: Our results suggest that total cholesterol and triglycerides concentrations are associated with liver steatosis and significant hepatic fibrosis are associated with lower total cholesterol and higher AST concentrations in patients with NAFLD according Fibroscan®.

scholarly journals Microbiota analysis and transient elastography reveal new extra-hepatic components of liver steatosis and fibrosis in obese patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nicolas Lanthier ◽  
Julie Rodriguez ◽  
Maxime Nachit ◽  
Sophie Hiel ◽  
Pierre Trefois ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Transient Elastography ◽  
Fasting Blood Glucose ◽  
Liver Steatosis ◽  
Liver Stiffness ◽  
Multivariate Logistic Regression Analysis ◽  
Rrna Gene ◽  
Obese Patients ◽  
Skeletal Muscle Index ◽  
Linear Discriminant

AbstractObesity could lead to metabolic dysfunction-associated fatty liver disease (MAFLD), which severity could be linked to muscle and gut microbiota disturbances. Our prospective study enrolled 52 obese patients whose MAFLD severity was estimated by transient elastography. Patients with severe steatosis (n = 36) had higher ALAT values, fasting blood glucose levels as well as higher visceral adipose tissue area and skeletal muscle index evaluated by computed tomography. Patients with fibrosis (n = 13) had higher ASAT values, increased whole muscle area and lower skeletal muscle density index. In a multivariate logistic regression analysis, myosteatosis was the strongest factor associated with fibrosis. Illumina sequencing of 16S rRNA gene amplicon was performed on fecal samples. The relative abundance of fecal Clostridium sensu stricto was significantly decreased with the presence of liver fibrosis and was negatively associated with liver stiffness measurement and myosteatosis. In addition, 19 amplicon sequence variants were regulated according to the severity of the disease. Linear discriminant analysis effect size (LEfSe) also highlighted discriminant microbes in patients with fibrosis, such as an enrichment of Enterobacteriaceae and Escherichia/Shigella compared to patients with severe steatosis without fibrosis. All those data suggest a gut-liver-muscle axis in the pathogenesis of MAFLD complications.

Reliability of Transient Elastography as a non-Invasive Technique for Detection of Fibrosis in Budd Chiari Syndrome Patients after Endovascular Intervention

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed F Montasser ◽  
Eman M Barakat ◽  
Mohamed S Ghazy ◽  
Sara M Abdelhakam ◽  
Hend E Ebada ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Endovascular Intervention ◽  
Invasive Technique ◽  
Budd Chiari Syndrome ◽  
Metavir Score ◽  
Before And After ◽  
Chiari Syndrome

Abstract Aim of the work To test the reliability of fibroscan in detection of fibrosis in patients with Budd Chiari syndrome before and after endovascular intervention (after elimination of hepatic congestion). Background transient elastography (TE) is a noninvasive methodology that has been used to monitor liver stiffness in patients with chronic viral hepatitis. One of the limitations for accurate assessment of liver fibrosis by TE is the liver congestion. Liver congestion can result from Budd Chiari syndrome (BCS).The treatment of BCS is through restoring the flow of the blood between the portal vein to the inferior vena cava, which will lead to decongestion of the liver.TE, will be tested after liver decongestion for proper detection of liver fibrosis. Patients and methods This was a prospective cohort study conducted on 25 Egyptian patients with confirmed diagnosis of primary Budd-Chiari Syndrome (BCS) in the period from June 2017 to September 2019. TE was performed three days before endovascular intervention and three months after it. Liver biopsy was taken during the intervention for assessment of METAVIR score. Comparison was done between TE assessments before and after intervention in detection of the degree of liver fibrosis in comparison to METAVIR score measured in liver biopsy. Results FVLM was the most common hypercoagulable cause in the involved patients. There was significant drop in Liver Stiffness Measurements (LSM) measured three months post-intervention indicating improvement of liver fibrosis after relieving liver congestion but still not correlated to the METAVIR scores measured in the liver biopsy. Conclusion Liver congestion has high impact on Liver stiffness measurement giving overestimation which improves significantly after decongestion of the liver by the endovascular intervention.

Ultrasonic Adaptive Sound Speed Estimation for the Diagnosis and Quantification of Hepatic Steatosis: A Pilot Study

2018 ◽  
Vol 40 (06) ◽  
pp. 722-733 ◽  
Author(s):  
Marco Dioguardi Burgio ◽  
Marion Imbault ◽  
Maxime Ronot ◽  
Alex Faccinetto ◽  
Bernard E. Van Beers ◽  
...  
Keyword(s):  
Hepatic Steatosis ◽  
Sound Speed ◽  
Validation Cohort ◽  
Liver Steatosis ◽  
Receiver Operating Curve ◽  
Coefficient Of Determination ◽  
Proton Density ◽  
Speed Estimation ◽  
Training Cohort ◽  
Receiver Operating Curve Analysis

Abstract Purpose To evaluate the ability of a new ultrasound (US) method based on sound speed estimation (SSE) with respect to the detection, quantification, and grading of hepatic steatosis using magnetic resonance (MR) proton density fat fraction (PDFF) as the reference standard and to calculate one US fat index based on the patient’s SSE. Materials and Methods This study received local IRB approval. Written informed consent was obtained from patients. We consecutively included N = 50 patients as the training cohort and a further N = 50 as the validation cohort who underwent both SSE and abdominal MR. Hepatic steatosis was classified according to MR-PDFF cutoffs as: S0 ≤ 6.5 %, S1 6.5 to 16.5 %, S2 16.5 to 22 %, S3 ≥ 22 %. Receiver operating curve analysis was performed to evaluate the diagnostic performance of SSE in the diagnosis of steatosis (S1–S3). Based on the optimal data fit derived from our study, we proposed a correspondence between the MR-PDFF and a US fat index. Coefficient of determination R2 was used to evaluate fit quality and was considered robust when R2 > 0.6. Results The training and validation cohorts presented mean SSE values of 1.570 ± 0.026 and 1.568 ± 0.023 mm/µs for S0 and 1.521 ± 0.031 and 1.514 ± 0.019 mm/µs for S1–S3 (p < 0.01) patients, respectively. An SSE threshold of ≤ 1.537 mm/µs had a sensitivity of 80 % and a specificity of 85.7 % in the diagnosis of steatosis (S1-S3) in the training cohort. Robust correspondence between MR-PDFF and the US fat index was found both for the training (R2 = 0.73) and the validation cohort (R2 = 0.76). Conclusion SSE can be used to detect, quantify and grade liver steatosis and to calculate a US fat index.

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