Gut Liver.  2017 Sep;11(5):674-683. 10.5009/gnl16440.

Noninvasive Assessment of Advanced Fibrosis Based on Hepatic Volume in Patients with Nonalcoholic Fatty Liver Disease

• Hayashi T
• Saitoh S
• Fukuzawa K
• Tsuji Y
• Takahashi
• Kawamura Y
• Akuta N
• Kobayashi
• Ikeda K
• Fujii T
• Miyati T
• Kumada H

• KMID: 2389356
• DOI: http://doi.org/10.5009/gnl16440

Abstract

BACKGROUND/AIMS
Noninvasive liver fibrosis evaluation was performed in patients with nonalcoholic fatty liver disease (NAFLD). We used a quantitative method based on the hepatic volume acquired from gadoxetate disodium-enhanced (Gd-EOB-DTPA-enhanced) magnetic resonance imaging (MRI) for diagnosing advanced fibrosis in patients with NAFLD.
METHODS
A total of 130 patients who were diagnosed with NAFLD and underwent Gd-EOB-DTPA-enhanced MRI were retrospectively included. Histological data were available for 118 patients. Hepatic volumetric parameters, including the left hepatic lobe to right hepatic lobe volume ratio (L/R ratio), were measured. The usefulness of the L/R ratio for diagnosing fibrosis ≥F3-4 and F4 was assessed using the area under the receiver operating characteristic (AUROC) curve. Multiple regression analysis was performed to identify variables (age, body mass index, serum fibrosis markers, and histological features) that were associated with the L/R ratio.
RESULTS
The L/R ratio demonstrated good performance in differentiating advanced fibrosis (AUROC, 0.80; 95% confidence interval, 0.72 to 0.88) from cirrhosis (AUROC, 0.87; 95% confidence interval, 0.75 to 0.99). Multiple regression analysis showed that only fibrosis was significantly associated with the L/R ratio (coefficient, 0.121; p<0.0001).
CONCLUSIONS
The L/R ratio, which is not influenced by pathological parameters other than fibrosis, is useful for diagnosing cirrhosis in patients with NAFLD.

Keyword

Liver cirrhosis; Fibrosis; Gadoxetate disodium; Magnetic resonance imaging; Non-alcoholic fatty liver disease

MeSH Terms

Body Mass Index
Fibrosis*
Humans
Liver Cirrhosis
Magnetic Resonance Imaging
Methods
Non-alcoholic Fatty Liver Disease*
Retrospective Studies
ROC Curve