Evaluating the severity of nonalcoholic steatohepatitis with superparamagnetic iron oxide-enhanced magnetic resonance imaging.
OBJECTIVE
To evaluate the utility of noninvasive assessment of human nonalcoholic fatty liver disease (NAFLD) patients using superparamagnetic iron oxide (SPIO)-enhanced MRI.


METHODS
Nineteen NAFLD patients underwent SPIO-enhanced MRI. The values of tau, a time constant for an exponential approximation, were calculated using gradient-echo echo-planar imaging, and the values of %T2, a marker of the T2 relaxation effect of SPIO, were calculated using T2-weighted fast spin-echo images. Correlations between these values and the histological NAFLD activity scores were evaluated. The study protocol was approved by our Institutional Review Board and all patients gave informed consent.


RESULTS
There was a statistically significant relationship between the NAFLD activity scores and the tau values (r = 0.66, P = 0.002). The %T2 values were also significantly correlated with the NAFLD activity score (r = -0.58, P = 0.009). A cutoff tau value of 42.8 predicted "definitive NASH" (NAFLD activity score >or=5) with a specificity of 66.7% and a sensitivity of 99.9%, whereas a cutoff %T2 value of 32.5 predicted "definitive NASH" with a specificity of 72.7% and a sensitivity of 87.5%.


CONCLUSIONS
Noninvasive SPIO-enhanced MRI may be helpful for identifying NASH patients among patients suspected of having NAFLD.
Tomita
Kengo
K
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Tanimoto
Akihiro
A
Irie
Rie
R
Kikuchi
Masahiro
M
Yokoyama
Hirokazu
H
Teratani
Toshiaki
T
Suzuki
Takahiro
T
Taguchi
Takashi
T
Noguchi
Masaaki
M
Ohkura
Tamiko
T
Hibi
Toshifumi
T
D000328:Adult; D003287:Contrast Media; D003911:Dextrans; D005234:Fatty Liver / Q000473:pathology*; D005260:Female; D052203:Ferrosoferric Oxide; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007501:Iron; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D010087:Oxides; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; D007501:Iron; C065507:ferumoxides; D052203:Ferrosoferric Oxide