Determination of liver triglycerides by 1H MR spectroscopy
Authors:
Milan Hájek 1; Monika Dezortová 1; Dita Wagnerová 1; Luděk Voska 2; Irena Hejlová 3; Pavel Trunečka 3
Authors‘ workplace:
Institut klinické a experimentální medicíny Praha, MR spektroskopie, Základna radiodiagnostiky a intervenční radiologie
1; Institut klinické a experimentální medicíny Praha, Pracoviště klinické a transplantační patologie
2; Institut klinické a experimentální medicíny Praha, Klinika hepatogastroenterologie
3
Published in:
Čas. Lék. čes. 2011; 150: 68-71
Category:
Original Article
Overview
Background:
Metabolic syndrome is responsible for increasing the fat content of the liver. Among several non-invasive methods of liver fat analysis, the most important role is played by magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS). This pilot study describes the methodology for measurements of triglycerides in the liver in a group of liver transplant patients using 1H MRS at 3T.
Methods and results:
Thirty-eight patients (12 female, 27 male, aged 19–71) who underwent routine preventive examination at IKEM were included in the MRS study. The fat content of liver biopsies was classified according to the number of affected hepatocytes, HIS. Based on this classification, there were 20 patients with a steatosis score of S0, 15 patients with a score of S1, 2 patients with a score of S2 and 1 patient with a score of S3. 1H MR spectra were measured from three positions in the liver. Following Longo et al, the concentration of fat φfat was calculated from the signal intensities of water and triglycerides. Linear correlation between the number of affected hepatocytes and fat content was described by the equation: HIS = 6.4 φfat –2.1; r2 = 0.85; p = 0.001.
Conclusions:
The pilot study confirmed that examination of fat content using 1H MRS at 3T is well tolerated by patients. Significant correlation was found between the results of histology and 1H MRS measurement of liver fat content. The method is suitable for non-invasive repetitive and screening examination measurement of fat in the liver.
Key words:
metabolic syndrome, liver steatosis, determination of triglycerides, 1H MR spectroscopy.
Sources
1. Hůlek P, Dresslerová I. Metabolický syndrom a játra (NAFLD/NASH). Vnitř Lék 2009; 55(7/8): 646–649.
2. Springer F, Machann J, Claussen CD, Schick F, Schwenzer NF. Liver fat content determined by magnetic resonance imaging and spectroscopy. World J Gastroenterol 2010; 16(13): 1560–1566.
3. Schwenzer NF, Springer F, Schraml C, Stefan N, Machann J, Schick F. Non-invasive assessment and quantification of liver steatosis by ultrasound, computed tomography and magnetic resonance. J Hepatol 2009; 51(3): 433–445.
4. Hübscher SG. Histological assessment of non-alcoholic fatty liver disease. Histopathology 2006; 49(5): 450–465.
5. Longo R, Pollesello P, Ricci C, Masutti F, Kvam BJ, Bercich L, CrocŹ LS, Grigolato P, Paoletti S, de Bernard B, et al. Proton MR spectroscopy in quantitative in vivo determination of fat content in human liver steatosis. J Magn Reson Imaging 1995; 5(3): 281–285.
6. Hu HH, Kim H-W, Batak KS, Nayak KS, Goran MI. Comparison of fat-water MRI and single-voxel MRS in the assessment of hepatic and pancreatic fat fractions in humans. Obesity (Silver Spring) 2010; 18(4): 841–847.
7. Guiu B, Petit JM, Loffroy R, Salem DB, Aho S, Masson D, Hillon P, Krause D, Cercueil JP. Quantification of liver fat content: comparison of triple-echo chemical shift gradient-echo imaging and in vivo proton MR spectroscopy. Radiology 2009; 250(1): 95–102.
8. Guiu B, Loffroy R, Petit JM, Aho S, Salem DB, Masson D, Hillon P, Cercueil JP, Krause D. Mapping of liver fat with triple-echo gradient echo imaging. validation against 3.0 T proton MR spectroscopy. Eur Radiol 2009; 19(7): 1786–1793.
9. Hájek M, Horská A, Belán A, Táborský P, Grosmanová A. Využití 31P MR spektroskopie při studiu kosterního svalstva člověka. Prakt Lek 1990; 70: 538–544.
10. Hajek M. (guest editor) Clinical 1H MR Spectroscopy. Eur J Radiol 2008; 67(2): 183–275.
11. Kleiner DE, Brunt EM, Van Natta M, Behling C, Contos MJ, Cummings OW, Ferrell LD, Liu YC, Torbenson MS, Unalp-Arida A, Yeh M, McCullough AJ, Sanyal AJ. Nonalcoholic Steatohepatitis Clinical Research Network. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 2005; 41(6): 1313–1321.
12. Searle JW, Kerr JFR, Halliday JW, Powel LW. Iron storage disease. MacSween RNM, Anthony PP, Scheuer PJ. (eds.) Pathology of the liver, 2nd edn. Edinburgh: Churchill Livingstone 1987.
13. Provencher SW. Estimation of metabolite concentrations from localized in vivo proton NMR spectra. Magn Reson Med 1993; 30(6): 672–679.
14. McPherson S, Jonsson JR, Cowin GJ, O’Rourke P, Clouston AD, Volp A, Horsfall L, Jothimani D, Fawcett J, Galloway GJ, Benson M, Powell EE. Magnetic resonance imaging and spectroscopy accurately estimate the severity of steatosis provided the stage of fibrosis is considered. J Hepatol 2009; 51(2): 389–397.
15. Krššák M, Hofer H, Wrba F, Meyerspeer M, Brehm A, Lohninger A, Steindl-Munda P, Moser E, Ferenci P, Roden M. Non-invasive assessment of hepatic fat accumulation in chronic hepatitis C by 1H magnetic resonance spectroscopy. Eur J Radiol 2010; 74(3): e60–66.
16. d’Assignies G, Ruel M, Khiat A, Lepanto L, Chagnon M, Kauffmann C, Tang A, Gaboury L, Boulanger Y. Noninvasive quantitation of human liver steatosis using magnetic resonance and bioassay methods. Eur Radiol 2009; 19(8): 2033–2040.
17. Szczepaniak LS, Nurenberg P, Leonard D, Browning JD, Reingold JS, Grundy S, Hobbs HH, Dobbins RL. Magnetic resonance spectroscopy to measure hepatic triglyceride content. prevalence of hepatic steatosis in the general population. Am J Physiol Endocrinol Metab 2005; 288(2): E462–468.
Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistArticle was published in
Journal of Czech Physicians
Most read in this issue
- Acute liver failure: Present recommendations
- Hyperglycemia and its control in the critically ill patient
- Kidney transplantation at the Institute for Clinical and Experimental Medicine
- Eversion carotid endarterectomy: evaluation of results after changing the operation technique