Magnetic resonance imaging-proton density fat fraction distribution characteristics of non-alcoholic fatty liver disease in overweight/obese children

SONG Huadan; LIU Ming; LIU Huanhuan; YIN Qiufeng; YAN Yongqing; WANG Qiang; ZHANG Jing; ZHAO Yi; ZHAO Xiance; LI Jinning nbsp

doi:10.19732/j.cnki.2096-6210.2023.04.005

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Magnetic resonance imaging-proton density fat fraction distribution characteristics of non-alcoholic fatty liver disease in overweight/obese children

更新时间：2025-12-15

- Magnetic resonance imaging-proton density fat fraction distribution characteristics of non-alcoholic fatty liver disease in overweight/obese children
- Vol. 32, Issue 4, Pages: 339-346(2023)
- 作者机构：
  
  1. 上海交通大学医学院附属新华医院放射科,上海,200092
  2. 飞利浦医疗保健事业部,上海,200042
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2023.04.005
  CLC：
- Published Online：13 September 2023，
  
  Published：13 September 2023
- 稿件说明：
移动端阅览
宋华丹,刘明,刘欢欢,等. 超重/肥胖儿童非酒精性脂肪性肝病的磁共振成像质子密度脂肪分数分布特点[J]. 肿瘤影像学, 2023, 32(4): 339-346 https://doi.

org/10.19732/j.cnki.2096-6210.2023.04.005
宋华丹,刘明,刘欢欢,等. 超重/肥胖儿童非酒精性脂肪性肝病的磁共振成像质子密度脂肪分数分布特点[J]. 肿瘤影像学, 2023, 32(4): 339-346 https://doi. DOI： 10.19732/j.cnki.2096-6210.2023.04.005.

org/10.19732/j.cnki.2096-6210.2023.04.005 DOI：

摘要

目的：

探讨超重/肥胖儿童非酒精性脂肪性肝病（non-alcoholic fatty liver disease，NAFLD）的磁共振成像质子密度脂肪分数（magnetic resonance imaging-proton density fat fraction，MRI-PDFF）分布特点，为未来NAFLD患儿肝脏脂肪含量评估标准方案的制订提供参考依据。

方法：

入组2022年8月—2023年3月在上海交通大学医学院附属新华医院行上腹部3.0 T MRI m-Dixon-quant序列扫描的超重/肥胖儿童受试者69例。收集入组受试者基本信息及实验室检查结果。根据全肝加权平均MRI-PDFF（weighted mean of MRI-PDFF，MRI-PDFF

）将受试者分为正常肝脏（Grade 0级）、轻度脂肪肝（Grade 1级）、中度脂肪肝（Grade 2级）及重度脂肪肝（Grade 3级）。分析肝段间MRI-PDFF的变异度及其与脂肪肝分级的关系。探讨肝脏各段MRI-PDFF（MRI-PDFF

Ⅰ-Ⅷ

）及其与MRI-PDFF

在脂肪肝诊断及分级中的一致性；比较PDFF

Ⅰ-Ⅷ

与丙氨酸转氨酶、天冬氨酸转氨酶及γ-谷氨酰转移酶的相关性。

结果：

69例入组受试者中确诊NAFLD患者58例（84.06%）。NAFLD患者MRI-PDFF

为（20.23±10.16）%，相较于其他肝段，MRI-PDFFV

Ⅱ

最高（22.23±9.85）%。MRI-PDFF

与MRI-PDFF

组内相关系数（intra-class correlation coefficient，ICC）最高（ICC=0.988，

＜0.001）。正常肝脏（2.59%）及轻度脂肪肝（7.15%）肝段间MRI-PDFF范围低于中、重度脂肪肝患者（9.71%~11.14%），组间差异有统计学意义（

＜0.001）。在诊断有无脂肪肝（Kappa值为1，

＜0.001）及脂肪肝分级（Kappa值为0.880，

＜0.001）方面，MRI-PDFF

与MRI-PDFF

一致性最高。MRI-PDFF

I-Ⅷ

与丙氨酸转氨酶均呈中度相关（

=0.415~0.470，

＜0.001），其中MRI-PDFF

Ⅳb

Abstract

Objective:

To investigate magnetic resonance imaging-proton density fat fraction (MRI-PDFF) distribution characteristics of non-alcoholic fatty liver disease (NAFLD) in overweight/obese children and to provide a reference for the development of the evaluation standard of liver fat quantification in children with NAFLD in the future.

Methods:

Enrolled 69 overweight/obese children who underwent 3.0 T magnetic resonance m-Dixon-quant sequence scanning of upper abdomen in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from August 2022 to March 2023. The MRI-PDFF

laboratory biochemical index

and measurement data of human body index in all patients were recorded. Patients were divided into four groups (Grade 0、Grade 1、Grade 2、Grade 3) according to the weighted mean of MRI-PDFF (MRI-PDFF

). Analyzed the variability of PDFF values between hepatic segments and their relationship with fatty liver grading. Explored the consistency between MRI-PDFF

I-Ⅷ

and MRI-PDFF

in the diagnosis and grading of fatty liver. Compared the correlation between MRI-PDFF

I-Ⅷ

with alanine aminotransferase (ALT)

aspartate aminotransferase (AST)

and gamma-glutamyl transferas (GGT).

Results:

Among the 69 participants

58 patients (84.06%) were diagnosed with NAFLD. The MRI-PDFF of the NAFLD patients was (20.23±10.16)%. Hepatic segment

Ⅶ

had the highest MRI-PDFF (22.23±9.85)%. Hepatic segment Ⅴ had the h

ighest intraclass correlation coefficient (ICC=0.988

＜0.001). The range of MRI-PDFF in normal liver (2.59%) and mild fatty liver (7.15%) was lower than that in patients with moderate to severe fatty liver (9.71%-11.14%)

with statistically significant differences (

＜0.001). In the diagnosis of the normal liver and fatty liver (Kappa value was 1

＜0.001) and fatty liver grading (Kappa value was 0.880

＜0.001)

MRI-PDFF V showed the best consistency with MRI-PDFF

. Liver MRI-PDFF

I-Ⅷ

had moderate and positive correlation with ALT (

=0.415-0.470

＜0.001)

and hepatic segment Ⅳb showed the highest correlation (

=0.470

＜0.001). Liver MRI-PDFF

I-Ⅷ

had slight and positive correlation with AST (

=0.252-0.337

＜0.005) and GGT (

=232-0.333

＜0.005).

Conclusion:

NAFLD has a high incidence in overweight/obese children

and the distribution of fat is usually uneven in the liver. The variability of hepatic fat distribution is increased with the degree of hepatic steatosis. Compared to other hepatic segments

MRI-PDFF

is more representative for the overall degree of liver steatosis and can be used as the preferred location for liver biopsy or other non-invasive quantitative evaluation. The liver fat content can reflect the damage degree of liver function to some extent.

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