Hepatic macrosteatosis: predicting appropriateness of liver donation by using MR imaging--correlation with histopathologic findings.
OBJECTIVE
To retrospectively evaluate the diagnostic performance of magnetic resonance (MR) imaging in predicting the appropriateness of liver donation in potential living liver donors by using histopathologic results as the reference standard.


METHODS
This study was approved by institutional review board; all patients gave informed consent for the use of MR data for future research. Fifty-seven potential liver donors (40 male, 17 female; age range, 17-57 years; mean age, 32 years) underwent dual-echo 1.5-T MR imaging. Two radiologists qualitatively graded each MR image, with consensus for disagreements. Livers were assigned one of three degrees of hepatic steatosis on the basis of changes in hepatic signal intensity (SI) between in-phase and opposed-phase images. For quantitative analysis, a third radiologist calculated mean hepatic and mean splenic SI by averaging 25 hepatic regions of interest and three splenic regions of interest. Relative SI decrease (RSID) in the liver on opposed-phase images compared with in-phase images was calculated. Linear regression analysis was used to correlate RSID with the degree of total steatosis, macrosteatosis, and microsteatosis. Diagnostic performance for predicting the appropriateness of liver donation was analyzed.


RESULTS
Histologic findings of macrosteatosis resulted in 52 patients being categorized as appropriate donors, with the remaining five being categorized as inappropriate donors. RSID was correlated with total steatosis (r = 0.850). When the RSID criterion for inappropriateness of liver donation was set at 20%, the sensitivity, specificity, and accuracy were 100%, 92.3%, and 93%, respectively. When RSID was used, four livers that had been misclassified as inappropriate for transplantation were found to have microsteatosis of various degrees and a less than moderate degree of macrosteatosis at histologic analysis. Qualitative and quantitative analyses were comparably accurate.


CONCLUSIONS
When an RSID criterion of less than 20% was used, dual-echo MR imaging facilitated the correct prediction of appropriateness of liver donation in 53 of 57 patients.
Kim
Se Hyung
SH
Department of Radiology, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea.
Lee
Jeong Min
JM
Han
Joon Koo
JK
Lee
Jae Young
JY
Lee
Kyoung Ho
KH
Han
Chang Jin
CJ
Jo
Jae Young
JY
Yi
Nam-Joon
NJ
Suh
Kyung-Suk
KS
Shin
Kyung-Sook
KS
Jo
Soo Yeon
SY
Choi
Byung Ihn
BI