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      Magnetic resonance imaging and liver histology as biomarkers of hepatic steatosis in children with nonalcoholic fatty liver disease.

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          Abstract

          Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children. In order to advance the field of NAFLD, noninvasive imaging methods for measuring liver fat are needed. Advanced magnetic resonance imaging (MRI) has shown great promise for the quantitative assessment of hepatic steatosis but has not been validated in children. Therefore, this study was designed to evaluate the correlation and diagnostic accuracy of MRI-estimated liver proton density fat fraction (PDFF), a biomarker for hepatic steatosis, compared to histologic steatosis grade in children. The study included 174 children with a mean age of 14.0 years. Liver PDFF estimated by MRI was significantly (P < 0.01) correlated (0.725) with steatosis grade. The correlation of MRI-estimated liver PDFF and steatosis grade was influenced by both sex and fibrosis stage. The correlation was significantly (P < 0.01) stronger in girls (0.86) than in boys (0.70). The correlation was significantly (P < 0.01) weaker in children with stage 2-4 fibrosis (0.61) than children with no fibrosis (0.76) or stage 1 fibrosis (0.78). The diagnostic accuracy of commonly used threshold values to distinguish between no steatosis and mild steatosis ranged from 0.69 to 0.82. The overall accuracy of predicting the histologic steatosis grade from MRI-estimated liver PDFF was 56%. No single threshold had sufficient sensitivity and specificity to be considered diagnostic for an individual child.

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          Author and article information

          Journal
          Hepatology
          Hepatology (Baltimore, Md.)
          1527-3350
          0270-9139
          Jun 2015
          : 61
          : 6
          Affiliations
          [1 ] Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Diego School of Medicine, San Diego, CA.
          [2 ] Department of Gastroenterology, Rady Children's Hospital San Diego, San Diego, CA.
          [3 ] Liver Imaging Group, Department of Radiology, University of California, San Diego School of Medicine, San Diego, CA.
          [4 ] Department of Pathology, Sharp Medical Center, San Diego, CA.
          [5 ] School of Medicine, Loma Linda University, Loma Linda, CA.
          [6 ] Center for Management Science in Health, Division of General Internal Medicine, Department of Medicine, University of California, San Diego School of Medicine, La Jolla, CA.
          [7 ] Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, CA.
          [8 ] Department of Pediatrics, University of California, San Diego School of Medicine, La Jolla, CA.
          Article
          NIHMS740361
          10.1002/hep.27666
          25529941
          © 2015 by the American Association for the Study of Liver Diseases.

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