The Accuracy and Clinical Relevance of the Multi-echo Dixon Technique for Evaluating Changes to Hepatic Steatosis in Patients with Non-alcoholic Fatty Liver Disease Treated with Formulated Food

Ying Yang; Kuanghui Xu; Xiaofei Chen; Jianping Ding; Junping Shi; Jie Li

doi:10.2463/mrms.mp.2021-0168

The Accuracy and Clinical Relevance of the Multi-echo Dixon Technique for Evaluating Changes to Hepatic Steatosis in Patients with Non-alcoholic Fatty Liver Disease Treated with Formulated Food

Magn Reson Med Sci. 2023 Apr 1;22(2):263-271. doi: 10.2463/mrms.mp.2021-0168. Epub 2022 Jun 7.

Authors

Ying Yang^{1

2}, Kuanghui Xu^{2

3}, Xiaofei Chen², Jianping Ding^{2

3}, Junping Shi^{3

4}, Jie Li²

Affiliations

¹ Department of Radiology, Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine.
² Department of Radiology, Hangzhou Normal University Affiliated Hospital.
³ Department of Clinical Medicine, Medical College, Hangzhou Normal University.
⁴ Department of Liver Diseases, Hangzhou Normal University Affiliated Hospital.

Abstract

Purpose: The Multi-echo Dixon (ME-Dixon) is a non-invasive quantitative MRI technique to diagnose non-alcoholic fatty liver disease (NAFLD). In this study, the hydrogen proton MR spectroscopy (¹H-MRS) was used as a reference to explore the accuracy of the ME-Dixon technique in evaluating hepatic steatosis in NAFLD patients after ingesting formulated food and its correlation with changes in clinical indicators.

Methods: Twenty-seven patients with NAFLD were enrolled. Fifteen patients completed 12 weeks of treatment with prebiotics and dietary fiber. In addition, abdominal MRI scans and blood tests were performed before and after treatment. The MRI-proton density fat fraction (MRI-PDFF) and MRS-PDFF were measured using the ME-Dixon and ¹H-MRS techniques. The Bland-Altman method and Pearson correlation analysis were used to test the consistency of the two techniques for measuring the liver fat content and the changed values. Besides, correlation analysis was conducted between the MRI-PDFF value and metabolic indicators.

Results: In the PDFF quantification of 42 person-times and the monitoring of the PDFF change in 15 patients under treatment, there was a good consistency and a correlation between MRI and MRS. At baseline, MRI-PDFF was positively correlated with insulin resistance index (HOMA-IR), fatty liver index (FLI), and liver enzymes. After treatment, the changes in MRI-PDFF were positively correlated with the recovery degree of FLI and liver enzymes.

Conclusion: ME-Dixon has a good consistency and a correlation with MRS in quantifying the liver fat content and monitoring the treatment effect, which may be used as an accurate indicator for clinical monitoring of changes in the liver fat content.

Keywords: fat fraction; magnetic resonance spectroscope; multi-echo Dixon technique; nonalcoholic fatty liver disease; prebiotics.

MeSH terms

Clinical Relevance
Humans
Liver / diagnostic imaging
Liver / pathology
Magnetic Resonance Imaging / methods
Magnetic Resonance Spectroscopy / methods
Non-alcoholic Fatty Liver Disease* / complications
Non-alcoholic Fatty Liver Disease* / diagnostic imaging
Non-alcoholic Fatty Liver Disease* / pathology
Protons

Substances

Protons

Grants and funding

This work was supported by the Social Development Project of Zhejiang Public Welfare Technology Research (grant No. LGF20H180016), the Project of Zhejiang Medical and health Science and Technology (grant No. 2020KY710), and the Project of Hangzhou Health, Science and Technology Plan (grant No. 0020190644, A20210057). This work was also supported by the Key medical disciplines of Hangzhou.