title: Hepatic fat quantification magnetic resonance for monitoring treatment response in pediatric nonalcoholic steatohepatitis.
abstract: OBJECTIVE
  To evaluate the possibility of treatment effect monitoring using hepatic fat quantification magnetic resonance (MR) in pediatric nonalcoholic steatohepatitis (NASH).
  
  
  METHODS
  We retrospectively reviewed the medical records of patients who received educational recommendations and vitamin E for NASH and underwent hepatic fat quantification MR from 2011 to 2013. Hepatic fat fraction (%) was measured using dual- and triple-echo gradient-recalled-echo sequences at 3T. The compliant and non-compliant groups were compared clinically, biochemically, and radiologically.
  
  
  RESULTS
  Twenty seven patients (M:F = 24:3; mean age: 12 ± 2.3 years) were included (compliant group = 22, non-compliant = 5). None of the baseline findings differed between the 2 groups, except for triglyceride level (compliant vs non-compliant, 167.7 mg/dL vs 74.2 mg/dL, P = 0.001). In the compliant group, high-density lipoprotein increased and all other parameters decreased after 1-year follow-up. However, there were various changes in the non-compliant group. Dual-echo fat fraction (-19.2% vs 4.6, P < 0.001), triple-echo fat fraction (-13.4% vs 3.5, P < 0.001), alanine aminotransferase (-110.7 IU/L vs -10.6 IU/L, P = 0.047), total cholesterol (-18.1 mg/dL vs 3.8 mg/dL, P = 0.016), and triglyceride levels (-61.3 mg/dL vs 11.2 mg/dL, P = 0.013) were significantly decreased only in the compliant group. The change in body mass index and dual-echo fat fraction showed a positive correlation (ρ = 0.418, P = 0.030).
  
  
  CONCLUSIONS
  Hepatic fat quantification MR can be a non-invasive, quantitative and useful tool for monitoring treatment effects in pediatric NASH.
authors.affiliation: Hong Koh, Seung Kim, Department of Pediatrics, Severance Pediatric Liver Disease Research Group, Severance Children's Hospital, Yonsei University College of Medicine, Seoul 120-752, South Korea.
authors.forename: Hong
authors.initials: H
authors.lastname: Koh
authors.affiliation: Hong Koh, Seung Kim, Department of Pediatrics, Severance Pediatric Liver Disease Research Group, Severance Children's Hospital, Yonsei University College of Medicine, Seoul 120-752, South Korea.
authors.forename: Seung
authors.initials: S
authors.lastname: Kim
authors.affiliation: Hong Koh, Seung Kim, Department of Pediatrics, Severance Pediatric Liver Disease Research Group, Severance Children's Hospital, Yonsei University College of Medicine, Seoul 120-752, South Korea.
authors.forename: Myung-Joon
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Hong Koh, Seung Kim, Department of Pediatrics, Severance Pediatric Liver Disease Research Group, Severance Children's Hospital, Yonsei University College of Medicine, Seoul 120-752, South Korea.
authors.forename: Hyun Gi
authors.initials: HG
authors.lastname: Kim
authors.affiliation: Hong Koh, Seung Kim, Department of Pediatrics, Severance Pediatric Liver Disease Research Group, Severance Children's Hospital, Yonsei University College of Medicine, Seoul 120-752, South Korea.
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Shin
authors.affiliation: Hong Koh, Seung Kim, Department of Pediatrics, Severance Pediatric Liver Disease Research Group, Severance Children's Hospital, Yonsei University College of Medicine, Seoul 120-752, South Korea.
authors.forename: Mi-Jung
authors.initials: MJ
authors.lastname: Lee
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism / Q000473:pathology*; D000293:Adolescent; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D002648:Child; D005260:Female; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008499:Medical Records; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000473:pathology* / Q000628:therapy*; D010349:Patient Compliance; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: Child; Hepatic fat quantification magnetic resonance; Monitoring; Nonalcoholic fatty liver disease; Steatohepatitis