Liver steatosis: investigation of opposed-phase T1-weighted liver MR signal intensity loss and visceral fat measurement as biomarkers.
OBJECTIVE
To investigate if opposed-phase T1-weighted and fat-suppressed T2-weighted liver signal intensity (SI) loss and visceral fat measurement at magnetic resonance (MR) imaging and body mass index (BMI) are correlated with grade of liver steatosis in patients with nonalcoholic fatty liver disease (NAFLD) or hepatitis C virus (HCV) and human immunodeficiency virus (HIV)-related liver disease.


METHODS
Committee on Human Research approval and patient consent were obtained for this HIPAA-compliant study. Fifty-two patients (15 men, 37 women) with NAFLD (n = 29) or HCV and HIV-related liver disease (n = 23) underwent prospective contemporaneous MR imaging and liver biopsy. Liver SI loss was measured on opposed-phase T1-weighted and fat-suppressed T2-weighted MR images. Visceral fat area was measured at three levels on water-suppressed T1-weighted MR images (n = 44). Spearman rank correlation coefficients and recursive partitioning were used to examine correlations.


RESULTS
Histopathologic liver steatosis correlated well with liver SI loss on opposed-phase T1-weighted MR images (rho = 0.78), fat-suppressed T2-weighted MR images (rho = 0.75), and average visceral fat area (rho = 0.77) (all P < .01) but poorly with BMI (rho = 0.53, P < .01). Liver SI losses on opposed-phase T1-weighted MR imaging of less than 3%, at least 3% but less than 35%, at least 35% but less than 49%, and at least 49% corresponded to histopathologic steatosis grades of 0 (n = 16 of 17), 1 (n = 11 of 16), 2 (n = 7 of 13), and 3 (n = 5 of 6), respectively. A visceral fat area of greater than or equal to 73.8 cm(2) was associated with the presence of histopathologic steatosis in 41 of 44 patients.


CONCLUSIONS
Liver SI loss on opposed-phase T1-weighted MR images and visceral fat area may be used as biomarkers for the presence of liver steatosis and appear to be superior to BMI.
Bahl
Manisha
M
Department of Radiology, University of California, San Francisco, Box 0628, L-307, 505 Parnassus Ave, San Francisco, CA 94143-0628, USA.
Qayyum
Aliya
A
Westphalen
Antonio C
AC
Noworolski
Susan M
SM
Chu
Philip W
PW
Ferrell
Linda
L
Tien
Phyllis C
PC
Bass
Nathan M
NM
Merriman
Raphael B
RB
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers; D001706:Biopsy; D015992:Body Mass Index; D002648:Child; D005234:Fatty Liver / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D015658:HIV Infections / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D050152:Intra-Abdominal Fat / Q000033:anatomy & histology*; D008099:Liver / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D015415:Biomarkers
Mayo Clin Proc. 1980 Jul;55(7):434-8
7382552
Int J Obes Relat Metab Disord. 2000 Jun;24 Suppl 2:S32-5
10997605
AJR Am J Roentgenol. 1991 Feb;156(2):307-12
1898804
Magn Reson Imaging. 1997;15(3):287-93
9201675
Int J Obes Relat Metab Disord. 1998 Mar;22(3):222-6
9539189
J Hepatol. 1997 Jul;27(1):108-13
9252082
Radiology. 1995 Nov;197(2):421-5
7480686
Gastroenterology. 2002 Sep;123(3):745-50
12198701
J Gastroenterol. 2006 May;41(5):462-9
16799888
Radiology. 2005 Nov;237(2):507-11
16244259
Semin Liver Dis. 2004 Nov;24(4):399-413
15605308
Clin Diagn Lab Immunol. 2005 Sep;12(9):1013-9
16148165
J Clin Endocrinol Metab. 1999 May;84(5):1513-7
10323371
Metabolism. 1993 May;42(5):548-51
8492707
Hepatology. 2005 Jun;41(6):1313-21
15915461
Radiology. 2004 Jan;230(1):276-80
14695401
Epidemiology. 1998 Mar;9(2):117-25
9504278
Int J Obes Relat Metab Disord. 1995 Apr;19(4):253-9
7627249
World J Gastroenterol. 2006 Nov 14;12(42):6756-65
17106922
Semin Liver Dis. 2001;21(1):71-80
11296698
Radiology. 2007 Feb;242(2):450-5
17255416
Eur J Ultrasound. 2001 Dec;14(2-3):121-8
11704429
J Gastroenterol Hepatol. 2002 Oct;17(10):1098-105
12201871
Gastroenterology. 2003 Jan;124(1):71-9
12512031
Semin Liver Dis. 2001;21(1):3-16
11296695
J Magn Reson Imaging. 1992 Jul-Aug;2(4):463-71
1633400
Ultrasound Med Biol. 1988;14(5):405-13
3051614
Obes Rev. 2004 Feb;5(1):27-42
14969505
Arch Med Res. 2007 Aug;38(6):634-43
17613355