MR Imaging of Non-Alcoholic Fatty Liver Disease

描述(由申请人提供)： 这项建议的目的是改进磁共振(MR)成像和光谱，为非酒精性脂肪性肝病(NAFLD)患者提供全面的非侵入性评估。 其具体目标是实施和发展MR方法来定性和定量评估肝脏：(1)脂肪、(2)纤维化和(3)炎症。 Dixon变体成像和光谱分析将用于评估脂肪。结合对比增强以及弥散加权和灌注成像获得的图像的形态和纹理分析将用于评估纤维化。这些技术的组合将被用于评估炎症。 从肝活检获得的定性和定量病理将作为参考标准。前瞻性、单中心、横断面和纵向临床研究将在儿童和成人中进行。特殊的影像和光谱特征将与组织学、生化和临床表现相关联。 这项拟议的研究是对非酒精性脂肪性肝炎临床研究网络的辅助，该网络是RFA确定的与肥胖相关的临床试验之一，本提案对此做出了回应。这项拟议的研究将完全纳入加州大学圣地亚哥分校(UCSD)的研究网络网站。加州大学圣迭戈分校是该网络中的八个临床中心之一。 目前诊断和监测NAFLD的临床金标准是活检。这与小但确定的风险有关，而且只对肝脏的一小部分进行采样，可能没有代表性。 由于肥胖率的增加，以及NAFLD进展为脂肪性肝炎、肝硬变和肝细胞癌的风险，对准确的非侵入性诊断的需求正在增加。 公共卫生声明。NAFLD是美国肝病的重要病因，正变得越来越常见，并影响到儿童和成人。开发一种安全、准确的方法来诊断和跟踪这种疾病，可能会导致更早的诊断和更有效的治疗。

DESCRIPTION (provided by applicant): The purpose of this proposal is to refine magnetic resonance (MR) imaging and spectroscopy to provide a comprehensive non-invasive assessment of patients with non-alcoholic fatty liver disease (NAFLD). The specific aims are to implement and develop MR methods to qualitatively and quantitatively assess liver: (1) fat, (2) fibrosis, and (3) inflammation. Dixon variant imaging and spectroscopy will be used to assess fat. Morphological and textural analysis of images obtained with combined contrast enhancement, as well as diffusion weighted and perfusion imaging will be used to assess fibrosis. A combination of these techniques will be used to assess inflammation. Both qualitative and quantitative pathology obtained from liver biopsies will be used as the reference standard. Prospective single-center cross-sectional and longitudinal clinical studies will be performed in children and adults. Specific imaging and spectroscopic features will be correlation by histological, biochemical, and clinical findings. The proposed study is ancillary to the Non-Alcoholic Steahohepatitis Clinical Research Network, one of the obesity-related clinical trials identified by the RFA to which this proposal responds. The proposed study will be fully integrated into the University of California San Diego (UCSD) site of the Research Netowrk. UCSD is one of eight Clinical Centers in the Network. The existing clinical gold standard for diagnosis and monitoring NAFLD is biopsy. This is associated with small but definite risks and samples only a small and possibly unrepresentative region of the liver. Because of the increasing prevalence of obesity, and the risk of progression of NAFLD to steatohepatltis, cirrhosis, and hepatocellular carcinoma, the need for accurate non-invasive diagnosis is increasing. Public health statement. NAFLD is an important cause of liver disease in the United States, is becoming more and more common and affects children and adults. Developing a safe and accurate method to diagnose and follow this disease may lead to earlier diagnosis and more effective treatment.