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    Proton magnetic resonance spectroscopy and ultrasound for hepatic fat quantification

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    Authors
    Mehta, Sanjeev R.
    Louise Thomas, Elizabeth
    Patel, Nayna
    Crofton, Mary E.
    McCarthy, John
    Eliahoo, Joseph
    Morin, Stanislas X.
    Fitzpatrick, Julie
    Durighel, Giuliana
    Goldstone, Anthony P.
    Johnston, Desmond G.
    Bell, Jimmy D.
    Taylor-Robinson, Simon D.
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    Affiliation
    Hammersmith Hospital
    Issue Date
    2010-04
    Subjects
    fatty liver disease
    proton magnetic resonance spectroscopy
    hepatic fat
    
    Metadata
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    Abstract
    Aim:  The increasing prevalence of fatty liver disease requires routine assessment methods. Proton magnetic resonance spectroscopy (1H MRS) is increasingly used for steatosis measurement, but due to cost, is unlikely to become a widely-used screening tool. Ultrasound is cheaper and more widely available, although subject to observer variability. Our aim was to determine the sensitivity and specificity of ultrasound against 1H MRS, using MRS as a gold standard, for the detection and quantification of hepatic fat content. Methods:  Fifty adults participated (43 men, seven women) in this study. Hepatic steatosis was assessed by ultrasound and 1H MRS. Images were graded by two independent radiologists to classify severity and distribution of liver fat. Results:  Ultrasound detected liver fat infiltration in 82% of cases measurable by 1H MRS, while liver fat was detectable in 44% of cases graded absent by ultrasound. Ultrasound grading was subjective, with the radiologists in agreement in 53% of cases (κ = 0.39, P = 0.002). Considerable overlap in intrahepatocellular lipid content was observed between different grades: absent (0.0–1.58%), mild (2.2–16.2%), moderate (4.9–26.7%) and severe (8.1–76.8%) steatosis. Ultrasound could not detect liver fat levels below 2% as measured by 1H MRS Conclusion:  Ultrasound is less sensitive than 1H MRS in detecting very low levels of liver fat content, but is sensitive to fatty infiltration greater than 2%. There is a tendency of higher ultrasound grades to correlate with higher degrees of fatty infiltration, although some overlap exists. Our findings are still consistent with ultrasound being useful as a low cost screening tool.
    Citation
    Mehta, S.R. et al (2010) 'Proton magnetic resonance spectroscopy and ultrasound for hepatic fat quantification'. Hepatology Research 40 (4):399
    Publisher
    Wiley
    Journal
    Hepatology Research
    URI
    http://hdl.handle.net/10547/594762
    DOI
    10.1111/j.1872-034X.2009.00620.x
    PubMed ID
    20236356
    Additional Links
    http://doi.wiley.com/10.1111/j.1872-034X.2009.00620.x
    Type
    Article
    Language
    en
    ISSN
    1386-6346
    1872-034X
    ae974a485f413a2113503eed53cd6c53
    10.1111/j.1872-034X.2009.00620.x
    Scopus Count
    Collections
    Muscle Cellular and Molecular Physiology

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