title: Chemical shift magnetic resonance imaging is helpful in detecting hepatic steatosis but not fibrosis in patients with nonalcoholic fatty liver disease (NAFLD).
abstract: OBJECTIVE
  Imaging modalities have a role in the diagnosis of patients with nonalcoholic fatty liver disease. Aim of the present study was to evaluate the role of chemical shift magnetic resonance imaging in assessing hepatic steatosis and fibrosis in patients with nonalcoholic fatty liver disease.
  
  
  METHODS
  Chemical shift magnetic resonance imaging was done in 10 biopsy proven patients (7 females, mean age 41 +/- 9.2 years) with nonalcoholic fatty liver disease. Objective measurements of signal intensity (SI) were done and a ratio was calculated (SI out-of- phase liver/ SI out-of- phase kidney)/ (SI in- phase liver/ SI in-phase kidney). A lower ratio indicated a higher signal drop and hence higher fat content. The ratio was correlated with hepatic steatosis on histology (< 33% and > 33%). Patients were classified as having histological NASH or no NASH and MRI was assessed in diagnosing hepatic fibrosis as seen on liver histology.
  
  
  RESULTS
  Six patients had > 33% hepatic steatosis on histology. Five patients (50%) had evidence of histological NASH. MRI was not helpful in differentiating patients with and without histological NASH. One patient amongst NASH patients did not have fibrosis, one had stage 1, 2 had stage 2 and one had stage 4 fibrosis. SI ratio ranged between 0.35-0.69 in 6 patients with steatosis > 33% and was in the range of 0.69-1.20 in four patients with steatosis < 33% on histology. Fibrotic changes seen in 4 patients on biopsy were not detected on MRI.
  
  
  CONCLUSIONS
  Chemical shift MRI provides objective data on fat infiltration in patients with NAFLD without giving information about hepatic fibrosis.
authors.affiliation: Department of Radiodiagnosis, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Naveen
authors.initials: N
authors.lastname: Kalra
authors.forename: Ajay
authors.initials: A
authors.lastname: Duseja
authors.forename: Ashim
authors.initials: A
authors.lastname: Das
authors.forename: Radha Krishan
authors.initials: RK
authors.lastname: Dhiman
authors.forename: Vivek
authors.initials: V
authors.lastname: Virmani
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Chawla
authors.forename: Paramjee
authors.initials: P
authors.lastname: Singh
authors.forename: Niranjan
authors.initials: N
authors.lastname: Khandelwal
mesh_terms: D000328:Adult; D001706:Biopsy; D005234:Fatty Liver / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index