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Chen H, Zeng WK, Shi GZ, Gao M, Wang MZ, Shen J. Liver fat accumulation measured by high-speed T2-corrected multi-echo magnetic resonance spectroscopy can predict risk of cholelithiasis. World J Gastroenterol 2020; 26:4996-5007. [PMID: 32952345 PMCID: PMC7476179 DOI: 10.3748/wjg.v26.i33.4996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/14/2020] [Accepted: 08/01/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Liver fat accumulation is associated with increased cholesterol synthesis and hypersecretion of biliary cholesterol, which may be related to the development of cholelithiasis.
AIM To investigate whether liver fat accumulation measured by high-speed T2-corrected multi-echo magnetic resonance spectroscopy (MRS) is a risk factor for cholelithiasis.
METHODS Forty patients with cholelithiasis and thirty-one healthy controls were retrospectively enrolled. The participants underwent high-speed T2-corrected multi-echo single-voxel MRS of the liver at a 3T MR scanner. The proton density fat fraction (PDFF) and R2 value were calculated. Serum parameters and waist circumference (WC) were recorded. Spearman’s correlation analysis was used to analyze the relationship between PDFF, R2, and WC values. Multivariate logistic regression analysis was carried out to determine the significant predictors of the risk of cholelithiasis. Receiver operating characteristic curve (ROC) analysis was used to evaluate the discriminative performance of significant predictors.
RESULTS Patients with cholelithiasis had higher PDFF, R2, and WC values compared with healthy controls (5.8% ± 4.2% vs 3.3% ± 2.4%, P = 0.001; 50.4 ± 24.8/s vs 38.3 ± 8.8/s, P = 0.034; 85.3 ± 9.0 cm vs 81.0 ± 6.9 cm, P = 0.030; respectively). Liver iron concentration extrapolated from R2 values was significantly higher in the cholelithiasis group (2.21 ± 2.17 mg/g dry tissue vs 1.22 ± 0.49 mg/g dry tissue, P = 0.034) than in the healthy group. PDFF was positively correlated with WC (r = 0.502, P < 0.001) and R2 (r = 0.425, P < 0.001). Multivariate logistic regression analysis showed that only PDFF was an independent risk factor for cholelithiasis (odds ratio = 1.79, 95%CI: 1.22-2.62, P = 0.003). ROC analysis showed that the area under the curve of PDFF was 0.723 for discriminating cholelithiasis from healthy controls, with a sensitivity of 55.0% and specificity of 83.9% when the cut-off value of PDFF was 4.4%.
CONCLUSION PDFF derived from high speed T2-corrected multi-echo MRS can predict the risk of cholelithiasis.
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Affiliation(s)
- Hong Chen
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China
| | - Wei-Ke Zeng
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China
| | - Guang-Zi Shi
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China
| | - Ming Gao
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China
| | - Meng-Zhu Wang
- Department of MR Scientific Marketing, Siemens Healthineers, Guangzhou 510120, Guangdong Province, China
| | - Jun Shen
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China
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Kühn JP, Meffert P, Heske C, Kromrey ML, Schmidt CO, Mensel B, Völzke H, Lerch MM, Hernando D, Mayerle J, Reeder SB. Prevalence of Fatty Liver Disease and Hepatic Iron Overload in a Northeastern German Population by Using Quantitative MR Imaging. Radiology 2017; 284:706-716. [PMID: 28481195 DOI: 10.1148/radiol.2017161228] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose To quantify liver fat and liver iron content by measurement of confounder-corrected proton density fat fraction (PDFF) and R2* and to identify clinical associations for fatty liver disease and liver iron overload and their prevalence in a large-scale population-based study. Materials and Methods From 2008 to 2013, 2561 white participants (1336 women; median age, 52 years; 25th and 75th quartiles, 42 and 62 years) were prospectively recruited to the Study of Health in Pomerania (SHIP). Complex chemical shift-encoded magnetic resonance (MR) examination of the liver was performed, from which PDFF and R2* were assessed. On the basis of previous histopathologic calibration, participants were stratified according to their liver fat and iron content as follows: none (PDFF, ≤5.1%; R2*, ≤41.0 sec-1), mild (PDFF, >5.1%; R2*, >41 sec-1), moderate (PDFF, >14.1%; R2*, >62.5 sec-1), high (PDFF: >28.0%; R2*: >70.1 sec-1). Prevalence of fatty liver diseases and iron overload was calculated (weighted by probability of participation). Clinical associations were identified by using boosting for generalized linear models. Results Median PDFF was 3.9% (range, 0.6%-41.5%). Prevalence of fatty liver diseases was 42.2% (1082 of 2561 participants); mild, 28.5% (730 participants); moderate, 12.0% (307 participants); high content, 1.8% (45 participants). Median R2* was 34.4 sec-1 (range, 14.0-311.8 sec-1). Iron overload was observed in 17.4% (447 of 2561 participants; mild, 14.7% [376 participants]; moderate, 0.8% [20 participants]; high content, 2.0% [50 participants]). Liver fat content correlated with waist-to-height ratio, alanine transaminase, uric acid, serum triglycerides, and blood pressure. Liver iron content correlated with mean serum corpuscular hemoglobin, male sex, and age. Conclusion In a white German population, the prevalence of fatty liver diseases and liver iron overload is 42.2% (1082 of 2561) and 17.4% (447 of 2561). Whereas liver fat is associated with predictors related to the metabolic syndrome, liver iron content is mainly associated with mean serum corpuscular hemoglobin. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Jens-Peter Kühn
- From the Institute of Diagnostic Radiology and Neuroradiology (J.P.K., C.H., M.L.K., C.O.S., B.M.), Institute for Community Medicine (P.M., H.V.), and Department of Medicine A, University Medicine (M.M.L., J.M.), Ernst Moritz Arndt University Greifswald, Berthold-Beitz-Platz, 17495 Greifswald, Germany; Department of Radiology, University of Wisconsin, Madison, Wis (D.H., S.B.R.); and Department of Medical Physics, Biomedical Engineering, Medicine and Emergency Medicine, University of Wisconsin, Madison, Wis (S.B.R.)
| | - Peter Meffert
- From the Institute of Diagnostic Radiology and Neuroradiology (J.P.K., C.H., M.L.K., C.O.S., B.M.), Institute for Community Medicine (P.M., H.V.), and Department of Medicine A, University Medicine (M.M.L., J.M.), Ernst Moritz Arndt University Greifswald, Berthold-Beitz-Platz, 17495 Greifswald, Germany; Department of Radiology, University of Wisconsin, Madison, Wis (D.H., S.B.R.); and Department of Medical Physics, Biomedical Engineering, Medicine and Emergency Medicine, University of Wisconsin, Madison, Wis (S.B.R.)
| | - Christian Heske
- From the Institute of Diagnostic Radiology and Neuroradiology (J.P.K., C.H., M.L.K., C.O.S., B.M.), Institute for Community Medicine (P.M., H.V.), and Department of Medicine A, University Medicine (M.M.L., J.M.), Ernst Moritz Arndt University Greifswald, Berthold-Beitz-Platz, 17495 Greifswald, Germany; Department of Radiology, University of Wisconsin, Madison, Wis (D.H., S.B.R.); and Department of Medical Physics, Biomedical Engineering, Medicine and Emergency Medicine, University of Wisconsin, Madison, Wis (S.B.R.)
| | - Marie-Luise Kromrey
- From the Institute of Diagnostic Radiology and Neuroradiology (J.P.K., C.H., M.L.K., C.O.S., B.M.), Institute for Community Medicine (P.M., H.V.), and Department of Medicine A, University Medicine (M.M.L., J.M.), Ernst Moritz Arndt University Greifswald, Berthold-Beitz-Platz, 17495 Greifswald, Germany; Department of Radiology, University of Wisconsin, Madison, Wis (D.H., S.B.R.); and Department of Medical Physics, Biomedical Engineering, Medicine and Emergency Medicine, University of Wisconsin, Madison, Wis (S.B.R.)
| | - Carsten O Schmidt
- From the Institute of Diagnostic Radiology and Neuroradiology (J.P.K., C.H., M.L.K., C.O.S., B.M.), Institute for Community Medicine (P.M., H.V.), and Department of Medicine A, University Medicine (M.M.L., J.M.), Ernst Moritz Arndt University Greifswald, Berthold-Beitz-Platz, 17495 Greifswald, Germany; Department of Radiology, University of Wisconsin, Madison, Wis (D.H., S.B.R.); and Department of Medical Physics, Biomedical Engineering, Medicine and Emergency Medicine, University of Wisconsin, Madison, Wis (S.B.R.)
| | - Birger Mensel
- From the Institute of Diagnostic Radiology and Neuroradiology (J.P.K., C.H., M.L.K., C.O.S., B.M.), Institute for Community Medicine (P.M., H.V.), and Department of Medicine A, University Medicine (M.M.L., J.M.), Ernst Moritz Arndt University Greifswald, Berthold-Beitz-Platz, 17495 Greifswald, Germany; Department of Radiology, University of Wisconsin, Madison, Wis (D.H., S.B.R.); and Department of Medical Physics, Biomedical Engineering, Medicine and Emergency Medicine, University of Wisconsin, Madison, Wis (S.B.R.)
| | - Henry Völzke
- From the Institute of Diagnostic Radiology and Neuroradiology (J.P.K., C.H., M.L.K., C.O.S., B.M.), Institute for Community Medicine (P.M., H.V.), and Department of Medicine A, University Medicine (M.M.L., J.M.), Ernst Moritz Arndt University Greifswald, Berthold-Beitz-Platz, 17495 Greifswald, Germany; Department of Radiology, University of Wisconsin, Madison, Wis (D.H., S.B.R.); and Department of Medical Physics, Biomedical Engineering, Medicine and Emergency Medicine, University of Wisconsin, Madison, Wis (S.B.R.)
| | - Markus M Lerch
- From the Institute of Diagnostic Radiology and Neuroradiology (J.P.K., C.H., M.L.K., C.O.S., B.M.), Institute for Community Medicine (P.M., H.V.), and Department of Medicine A, University Medicine (M.M.L., J.M.), Ernst Moritz Arndt University Greifswald, Berthold-Beitz-Platz, 17495 Greifswald, Germany; Department of Radiology, University of Wisconsin, Madison, Wis (D.H., S.B.R.); and Department of Medical Physics, Biomedical Engineering, Medicine and Emergency Medicine, University of Wisconsin, Madison, Wis (S.B.R.)
| | - Diego Hernando
- From the Institute of Diagnostic Radiology and Neuroradiology (J.P.K., C.H., M.L.K., C.O.S., B.M.), Institute for Community Medicine (P.M., H.V.), and Department of Medicine A, University Medicine (M.M.L., J.M.), Ernst Moritz Arndt University Greifswald, Berthold-Beitz-Platz, 17495 Greifswald, Germany; Department of Radiology, University of Wisconsin, Madison, Wis (D.H., S.B.R.); and Department of Medical Physics, Biomedical Engineering, Medicine and Emergency Medicine, University of Wisconsin, Madison, Wis (S.B.R.)
| | - Julia Mayerle
- From the Institute of Diagnostic Radiology and Neuroradiology (J.P.K., C.H., M.L.K., C.O.S., B.M.), Institute for Community Medicine (P.M., H.V.), and Department of Medicine A, University Medicine (M.M.L., J.M.), Ernst Moritz Arndt University Greifswald, Berthold-Beitz-Platz, 17495 Greifswald, Germany; Department of Radiology, University of Wisconsin, Madison, Wis (D.H., S.B.R.); and Department of Medical Physics, Biomedical Engineering, Medicine and Emergency Medicine, University of Wisconsin, Madison, Wis (S.B.R.)
| | - Scott B Reeder
- From the Institute of Diagnostic Radiology and Neuroradiology (J.P.K., C.H., M.L.K., C.O.S., B.M.), Institute for Community Medicine (P.M., H.V.), and Department of Medicine A, University Medicine (M.M.L., J.M.), Ernst Moritz Arndt University Greifswald, Berthold-Beitz-Platz, 17495 Greifswald, Germany; Department of Radiology, University of Wisconsin, Madison, Wis (D.H., S.B.R.); and Department of Medical Physics, Biomedical Engineering, Medicine and Emergency Medicine, University of Wisconsin, Madison, Wis (S.B.R.)
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