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首页> 外文期刊>Hepatology: Official Journal of the American Association for the Study of Liver Diseases >Diagnostic accuracy of magnetic resonance imaging hepatic proton density fat fraction in pediatric nonalcoholic fatty liver disease
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Diagnostic accuracy of magnetic resonance imaging hepatic proton density fat fraction in pediatric nonalcoholic fatty liver disease

机译：磁共振成像肝质子密度脂肪分数诊断准确性小儿非酒精性脂肪肝病

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We assessed the performance of magnetic resonance imaging (MRI) proton density fat fraction (PDFF) in children to stratify hepatic steatosis grade before and after treatment in the Cysteamine Bitartrate Delayed‐Release for the Treatment of Nonalcoholic Fatty Liver Disease in Children (CyNCh) trial, using centrally scored histology as reference. Participants had multiecho 1.5 Tesla (T) or 3T MRI on scanners from three manufacturers. Of 169 enrolled children, 110 (65%) and 83 (49%) had MRI and liver biopsy at baseline and at end of treatment (EOT; 52 weeks), respectively. At baseline, 17% (19 of 110), 28% (31 of 110), and 55% (60 of 110) of liver biopsies showed grades 1, 2, and 3 histological steatosis; corresponding PDFF (mean?±?SD) values were 10.9?±?4.1%, 18.4?±?6.2%, and 25.7?±?9.7%, respectively. PDFF classified grade 1 versus 2‐3 and 1‐2 versus 3 steatosis with areas under receiving operator characteristic curves (AUROCs) of 0.87 (95% confidence interval [CI], 0.80, 0.94) and 0.79 (0.70, 0.87), respectively. PDFF cutoffs at 90% specificity were 17.5% for grades 2‐3 steatosis and 23.3% for grade 3 steatosis. At EOT, 47% (39 of 83), 41% (34 of 83), and 12% (10 of 83) of biopsies showed improved, unchanged, and worsened steatosis grade, respectively, with corresponding PDFF (mean?±?SD) changes of –7.8?±?6.3%, –1.2?±?7.8%, and 4.9?±?5.0%, respectively. PDFF change classified steatosis grade improvement and worsening with AUROCs (95% CIs) of 0.76 (0.66, 0.87) and 0.83 (0.73, 0.92), respectively. PDFF change cut‐off values at 90% specificity were –11.0% and +5.5% for improvement and worsening. Conclusion: MRI‐estimated PDFF has high diagnostic accuracy to both classify and predict histological steatosis grade and change in histological steatosis grade in children with NAFLD. (H epatology 2018;67:858–872)
机译：我们评估了儿童磁共振成像（MRI）质子密度脂肪分数（PDFF）的性能，以在半胱胺位止动液中治疗前后分层肝脏脂肪变性等级，用于治疗儿童（CYNCH）试验中的非酒精性脂肪肝病，使用集中评分组织学作为参考。参与者在三家制造商的扫描仪上有MultiCho 1.5 Tesla（T）或3T MRI。 169名招生的儿童，110名（65％）和83（49％）分别在基线和肝脏活组织检查分别在基线和治疗结束时（EOT; 52周）。在基线时，17％（110个），28％（110个）和55％（110个中）的肝活组织检查显示为1,2和3级组织学脂肪化;相应的PDFF（平均值α±sd）值为10.9？±4.1％，18.4？±6.2％，分别为25.7？±9.7％。 PDFF分类1级与2-3和1-2与3个脂肪变性分别在接受操作员特征曲线（Aurocs）下的区域分别为0.87（95％置信区间[CI]，0.80,0.94）和0.79（0.70,0.87）。 PDFF截止物90％的特异性为2-3级脂肪变性的17.5％，3级脂肪变性为23.3％。在EOT时，47％（39个83个），41％（83个）和12％（83个）的活组织检查分别显示出改善，不变和恶劣的脂肪变性等级，相应的PDFF（平均值？±α？SD ）变化-7.8？±6.3％，-1.2？±7.8％和4.9？±5.0％。 PDFF改变分类的脂肪变性等级改善和使0.76（0.66,0.87）和0.83（0.73,0.92）的菌射（95％CIs）的恶化。 PDFF改变90％特异性的截止值为-11.0％和+ 5.5％，以改善和恶化。结论：MRI估计的PDFF对分类和预测组织学脂肪变性等级以及NAFLD儿童组织脂肪变性等级的诊断准确性高。 （2018年Hopatology; 67：858-872）

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