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Can gadoxetic acid-enhanced magnetic resonance imaging be used to avoid liver biopsy in patients with nonalcoholic fatty liver disease?

Authors :
Amorim VB
Parente DB
Paiva FF
Oliveira Neto JA
Miranda AA
Moreira CC
Fernandes FF
Campos CFF
Leite NC
Perez RM
Rodrigues RS
Source :
World journal of hepatology [World J Hepatol] 2020 Sep 27; Vol. 12 (9), pp. 661-671.
Publication Year :
2020

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) is a major cause of liver disease worldwide. The diagnosis of nonalcoholic steatohepatitis (NASH), the most severe form of NAFLD, is crucial and has prognostic and therapeutic implications. However, currently this diagnosis is based on liver biopsy and has several limitations.<br />Aim: To evaluate the performance of gadoxetic acid-enhanced magnetic resonance imaging (GA-MRI) in differentiating isolated steatosis from NASH in patients with NAFLD.<br />Methods: In this prospective study, 56 patients with NAFLD (18 with isolated steatosis and 38 with NASH) underwent GA-MRI. The contrast enhancement index (CEI) was calculated as the rate of increase of the liver-to-muscle signal intensity ratio from before and 20 min after intravenous GA administration. Between-group differences in mean CEI were examined using Student's t test. The area under the receiver operator characteristic curve and the diagnostic performance of gadoxetic acid-enhanced magnetic resonance imaging were evaluated.<br />Results: The mean CEI for all subjects was 1.82 ± 0.19. The mean CEI was significantly lower in patients with NASH than in those with isolated steatosis ( P = 0.008). Two CEI cut-off points were used: < 1.66 (94% specificity) to characterize NASH and > 2.00 (89% sensitivity) to characterize isolated steatosis. CEI values between 1.66 and 2.00 indicated liver biopsy, and the procedure could be avoided in 40% of patients with NAFLD.<br />Conclusion: GA-MRI is an effective noninvasive method that may be useful for the differentiation of NASH from isolated steatosis, and could help to avoid liver biopsy in patients with NAFLD.<br /> (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)

Details

Language :
English
ISSN :
1948-5182
Volume :
12
Issue :
9
Database :
MEDLINE
Journal :
World journal of hepatology
Publication Type :
Academic Journal
Accession number :
33033571
Full Text :
https://doi.org/10.4254/wjh.v12.i9.661