What is the clinical evidence from this study?

Study design: Observational. Population: Hepatic steatosis (n=38). Intervention: Hepatic MRI (chemical shift imaging) vs. Ultrasound. Primary outcome: Correlation with microscopic fat content on liver biopsy (r = 0.77, p=<0.001).

July 13, 2005

Hepatic MRI for Fat Quantitation

Q: What are the key findings of this study?

Hepatic MRI demonstrated a significantly better correlation with microscopic fat content on biopsy than ultrasound (r=0.77 vs r=0.41, P<0.001).

Key Result

Hepatic MRI demonstrated a significantly better correlation with microscopic fat content on biopsy than ultrasound (r=0.77 vs r=0.41, P<0.001).

Study Design

Type

Observational (n=38)

Structured PICO

Does MRI provide better correlation with liver biopsy for quantifying hepatic steatosis compared to ultrasound in patients with liver disease?

Population

38 patients undergoing hepatic biopsy for a variety of liver diseases

Intervention

Hepatic MRI through chemical shift imaging

Comparator

Ultrasound through echogenicity (n=31)

Outcome

Correlation with microscopic fat content assessed by liver biopsysurrogate

MRI is superior to ultrasound in detecting and quantifying minor degrees of fatty metamorphosis in the liver, though both are useful for identifying heavy fat accumulation.

Main Result

Effect estimate: r = 0.77

p-value: p=<0.001

Abstract

PURPOSE: The value of MRI and ultrasound in quantifying hepatic steatosis is assessed and the results compared with those obtained by liver biopsies. METHODS: A total of 38 patients undergoing hepatic biopsy for a variety of liver diseases were recruited for this study. Hepatic fat morphology and severity were assessed visually in each biopsy specimen. Steatosis pattern included macrovesicular, microvesicular, or mixed. The severity of hepatic steatosis was assessed by MRI through chemical shift imaging (n = 38) and by ultrasound through echogenicity (n = 31). RESULTS: MRI had a better correlation than ultrasound for microscopic fat content (r = 0.77, P < 0.001 vs. r = 0.41, P < 0.05). In macrovesicular steatosis, MRI and ultrasound both correlated well with microscopic fat content (r = 0.92, P < 0.001 vs. r = 0.90, P < 0.001). In nonalcoholic fatty liver disease, ultrasound revealed severe steatosis in all instances, but MRI fat content ranged greatly (19%-40%). In diagnoses excluding nonalcoholic fatty liver disease, increasing ultrasound severity did not correspond to advanced MRI fat content. CONCLUSION: Hepatic MRI and ultrasound are both useful in identifying heavy fat accumulation associated with nonalcoholic fatty liver disease. MRI is superior to ultrasound in detecting and quantifying minor degrees of fatty metamorphosis in the liver.

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