Accuracy of MR Imaging-estimated Proton Density Fat Fraction for Classification of Dichotomized Histologic Steatosis Grades in Nonalcoholic Fatty Liver Disease
Accuracy of MR Imaging-estimated Proton Density Fat Fraction for Classification of Dichotomized Histologic Steatosis Grades in Nonalcoholic Fatty Liver Disease
复制标题
DOI：
10.1148/radiol.14140754
复制
发表时间：
2015-02-01
期刊：
影响因子：
19.7
通讯作者：
Sirlin, Claude B.
中科院分区：
文献类型：
--
作者：
Tang, An;Desai, Ajinkya;Sirlin, Claude B.
目的：通过使用组织学结果作为参考，评估先前提出的高特异性磁共振（MR）成像估计的质子密度脂肪分数（PDFF）阈值用于诊断1级或更高（PDFF阈值6.4％）、2级或更高（PDFF阈值17.4％）和3级（PDFF阈值22.1％）脂肪变性的诊断性能。 已知患有或疑似患有非酒精性脂肪性肝病 (NAFLD) 的独立队列。 材料和方法：这项前瞻性、横断面、机构审查委员会批准、符合 HIPAA 的单中心研究是在 89 名已知患有或疑似患有 NAFLD 的独立队列中进行的，这些成年人接受了同期肝活检。通过使用基于幅度的低翻转角多回波梯度回忆回波成像以及 T2* 校正和多峰建模，将 MR 成像 PDFF 估计为 3 T。脂肪变性按组织学分级（根据非酒精性脂肪性肝炎临床研究网络评分系统，0、1、2 和 3 级）。计算了建议的 MR 成像 PDFF 阈值的敏感性、特异性和二项置信区间。结果：建议的 6.4% 的 MR 成像 PDFF 阈值用于诊断 1 级或更高级别的脂肪变性，其敏感性为 86%（83 名患者中的 71 名；95% 置信区间 [CI]：76, 92）和 83% 特异性（6 名患者中的 5 名；95% CI：36, 100）。诊断 2 级或更高级别脂肪变性的阈值为 17.4%，敏感性为 64%（44 名患者中的 28 名；95% CI：48, 78），特异性为 96%（45 名患者中的 43 名；95% CI：85, 100）。诊断 3 级脂肪变性的阈值为 22.1%，敏感性为 71%（14 名患者中的 10 名；95% CI：42, 92），特异性为 92%（75 名患者中的 69 名；95% CI：83, 97）。结论：在已知患有或怀疑患有 NAFLD 的成人独立队列中，之前提出的 MR 成像 PDFF 阈值提供了中等到高敏感性和高敏感性。 诊断 1 级或以上、2 级或以上以及 3 级脂肪变性的特异性。现在需要进行前瞻性多中心研究来进一步验证这些高特异性阈值。 (C) 北美放射学会，2014
Purpose: To evaluate the diagnostic performance of previously proposed high-specificity magnetic resonance (MR) imaging-estimated proton density fat fraction (PDFF) thresholds for diagnosis of steatosis grade 1 or higher (PDFF threshold of 6.4%), grade 2 or higher (PDFF threshold of 17.4%), and grade 3 (PDFF threshold of 22.1%) by using histologic findings as a reference in an independent cohort of adults known to have or suspected of having nonalcoholic fatty liver disease (NAFLD).Materials and Methods: This prospective, cross-sectional, institutional review board-approved, HIPAA-compliant single-center study was conducted in an independent cohort of 89 adults known to have or suspected of having NAFLD who underwent contemporaneous liver biopsy. MR imaging PDFF was estimated at 3 T by using magnitude-based low-flip-angle multiecho gradient-recalled-echo imaging with T2* correction and multipeak modeling. Steatosis was graded histologically (grades 0, 1, 2, and 3, according to the Nonalcoholic Steatohepatitis Clinical Research Network scoring system). Sensitivity, specificity, and binomial confidence intervals were calculated for the proposed MR imaging PDFF thresholds.Results: The proposed MR imaging PDFF threshold of 6.4% to diagnose grade 1 or higher steatosis had 86% sensitivity (71 of 83 patients; 95% confidence interval [CI]: 76, 92) and 83% specificity (five of six patients; 95% CI: 36, 100). The threshold of 17.4% to diagnose grade 2 or higher steatosis had 64% sensitivity (28 of 44 patients; 95% CI: 48, 78) and 96% specificity (43 of 45 patients; 95% CI: 85, 100). The threshold of 22.1% to diagnose grade 3 steatosis had 71% sensitivity (10 of 14 patients; 95% CI: 42, 92) and 92% specificity (69 of 75 patients; 95% CI: 83, 97).Conclusion: In an independent cohort of adults known to have or suspected of having NAFLD, the previously proposed MR imaging PDFF thresholds provided moderate to high sensitivity and high specificity for diagnosis of grade 1 or higher, grade 2 or higher, and grade 3 steatosis. Prospective multicenter studies are now needed to further validate these high-specificity thresholds. (C) RSNA, 2014