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European Radiology
Published in: European Radiology 10/2015

01-10-2015 | Hepatobiliary-Pancreas

Comparison between modified Dixon MRI techniques, MR spectroscopic relaxometry, and different histologic quantification methods in the assessment of hepatic steatosis

Authors: Guido M. Kukuk, Kanishka Hittatiya, Alois M. Sprinkart, Holger Eggers, Jürgen Gieseke, Wolfgang Block, Philipp Moeller, Winfried A. Willinek, Ulrich Spengler, Jonel Trebicka, Hans-Peter Fischer, Hans H. Schild, Frank Träber

Published in: European Radiology | Issue 10/2015

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Abstract

Objectives

To compare systematically quantitative MRI, MR spectroscopy (MRS), and different histological methods for liver fat quantification in order to identify possible incongruities.

Methods

Fifty-nine consecutive patients with liver disorders were examined on a 3 T MRI system. Quantitative MRI was performed using a dual- and a six-echo variant of the modified Dixon (mDixon) sequence, calculating proton density fat fraction (PDFF) maps, in addition to single-voxel MRS. Histological fat quantification included estimation of the percentage of hepatocytes containing fat vesicles as well as semi-automatic quantification (qHisto) using tissue quantification software.

Results

In 33 of 59 patients, the hepatic fat fraction was >5 % as determined by MRS (maximum 45 %, mean 17 %). Dual-echo mDixon yielded systematically lower PDFF values than six-echo mDixon (mean difference 1.0 %; P < 0.001). Six-echo mDixon correlated excellently with MRS, qHisto, and the estimated percentage of hepatocytes containing fat vesicles (R = 0.984, 0.967, 0.941, respectively, all P < 0.001). Mean values obtained by the estimated percentage of hepatocytes containing fat were higher by a factor of 2.5 in comparison to qHisto. Six-echo mDixon and MRS showed the best agreement with values obtained by qHisto.

Conclusions

Six-echo mDixon, MRS, and qHisto provide the most robust and congruent results and are therefore most appropriate for reliable quantification of liver fat.

Key Points

• Six-echo mDixon correlates excellently with MRS, qHisto, and the estimated percentage of fat-containing hepatocytes.
• Six-echo mDixon, MRS, and qHisto provide the most robust and congruent results.
• Dual-echo mDixon yields systematically lower PDFF values than six-echo mDixon.
• The percentage of fat-containing hepatocytes is 2.5-fold higher than fat fraction determined by qHisto.
• Performance characteristics and systematic differences of the various methods should be considered.
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Metadata
Title
Comparison between modified Dixon MRI techniques, MR spectroscopic relaxometry, and different histologic quantification methods in the assessment of hepatic steatosis
Authors
Guido M. Kukuk
Kanishka Hittatiya
Alois M. Sprinkart
Holger Eggers
Jürgen Gieseke
Wolfgang Block
Philipp Moeller
Winfried A. Willinek
Ulrich Spengler
Jonel Trebicka
Hans-Peter Fischer
Hans H. Schild
Frank Träber
Publication date
01-10-2015
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3703-6

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