Non-invasive assessment of hepatic fat accumulation in chronic hepatitis C by 1H magnetic resonance spectroscopy.
BACKGROUND
Liver biopsy is the standard method for diagnosis of hepatic steatosis, but is invasive and carries some risk of morbidity.


OBJECTIVE
Quantification of hepatocellular lipid content (HCL) with non-invasive single voxel (1)H magnetic resonance spectroscopy (MRS) at 3T was compared with histological grading and biochemical analysis of liver biopsies in 29 patients with chronic hepatitis C. Body mass index, indices of insulin resistance (homeostasis model assessment index, HOMA-IR), serum lipids and serum liver transaminases were also quantified.


RESULTS
HCL as assessed by (1)H MRS linearly correlated (r=0.70, p<0.001) with histological evaluation of liver biopsies and was in agreement with histological steatosis staging in 65% of the patients. Biochemically assessed hepatic triglyceride contents correlated with HCL measured with (1)H MRS (r=0.63, p<0.03) and allowed discriminating between none or mild steatosis versus moderate or severe steatosis. Patients infected with hepatitis C virus genotype 3 had a higher prevalence of steatosis (62%) which was not explained by differences in body mass or whole body insulin resistance. When these patients were excluded from correlation analysis, hepatic fat accumulation positively correlated with insulin resistance in the remaining hepatitis C patients (HCL vs. HOMA-IR, r=0.559, p<0.020, n=17).


CONCLUSIONS
Localized (1)H MRS is a valid and useful method for quantification of HCL content in patients with chronic hepatitis C and can be easily applied to non-invasively monitoring of steatosis during repeated follow-up measurements in a clinical setting.
Krssák
Martin
M
Department of Internal Medicine III, Division of Endocrinology and Metabolism, Medical University of Vienna, Austria.
Hofer
Harald
H
Wrba
Fritz
F
Meyerspeer
Martin
M
Brehm
Attila
A
Lohninger
Alfred
A
Steindl-Munda
Petra
P
Moser
Ewald
E
Ferenci
Peter
P
Roden
Michael
M
D000273:Adipose Tissue / Q000378:metabolism*; D000328:Adult; D005234:Fatty Liver / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism*; D006801:Humans; D008055:Lipids / Q000032:analysis*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D011522:Protons; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D008055:Lipids; D011522:Protons