MRI and ultrasound for hepatic fat quantification:relationships to clinical and metabolic characteristics of pediatric nonalcoholic fatty liver disease

  1. Lucia Pacifico1,3,
  2. Michela Celestre2,
  3. Caterina Anania1,
  4. Pasquale Paolantonio2,
  5. Claudio Chiesa1,
  6. Andrea Laghi2

Article first published online: 14 FEB 2007

DOI: 10.1111/j.1651-2227.2007.00186.x

Issue

Acta Paediatrica

Acta Paediatrica

Volume 96, Issue 4, pages 542–547, April 2007

Additional Information

How to Cite

Pacifico, L., Celestre, M., Anania, C., Paolantonio, P., Chiesa, C. and Laghi, A. (2007), MRI and ultrasound for hepatic fat quantification:relationships to clinical and metabolic characteristics of pediatric nonalcoholic fatty liver disease. Acta Paediatrica, 96: 542–547. doi: 10.1111/j.1651-2227.2007.00186.x

Author Information

  1. 1

    Department of Pediatrics, La Sapienza University of Rome, Rome, Italy

  2. 2

    Department of Radiological Sciences, La Sapienza University of Rome, Polo Didattico Pontino, ICOT-Latina, Italy

  3. 3

    National Research Council, Rome, Italy

*Correspondence Claudio Chiesa, M.D., National Research Council- Department of Pediatrics, La Sapienza University of Rome, Viale Regina Elena, 324 00161-Rome, Italy. Tel and Fax: 39 06 4997 9216 | Email: claudio.chiesa@uniroma1.it

Publication History

  1. Issue published online: 22 MAR 2007
  2. Article first published online: 14 FEB 2007
  3. Received 9 October 2006; revised 22 November 2006; accepted 20 December 2006

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Keywords:

  • Insulin resistance;
  • MRI;
  • NAFLD;
  • Obese children;
  • Ultrasound

Abstract

Objective: The aims of this study were to evaluate hepatic steatosis severity in a series of obese children through both magnetic resonance imaging (MRI) and ultrasound, and to correlate imaging findings to clinical and metabolic characteristics of the study population.

Methods: Fifty obese children presenting hepatomegaly and/or elevated aminotransferases were candidates for assessment of hepatic fat fraction (HFF) by MRI. All subjects underwent dual energy X-ray absorptiometry scan measurement, and liver ultrasound scanning. Fasting blood samples were taken for the estimation of serum concentrations of glucose, insulin, leptin, aminotransferases and serum lipid profile.

Results: A diagnosis of fatty liver was established by MRI in 20 (40%) children; of these, 12 had HFF of 9–18%, while the remaining ones had HFF of 19% or higher. HFF was not correlated to age, SDS-BMI, pubertal status and fat mass. HFF was positively associated with serum concentrations of alanine aminotransferase (ALT; r = 0.62; p < 0.0001) and AST (r = 0.39; p = 0.006), as well as with insulin (r = 0.44; p = 0.001) and insulin resistance (r = 0.49; p < 0.0001). Overall, ultrasound correlated well with MRI (p < 0.0001). However, HFF ranged greatly in subjects with moderate (2–37%) as well as with severe (11–25%) degree of ultrasound hepatic steatosis. In fact, the mean hepatic fat fraction in children with severe steatosis was not statistically different from that found in patients with moderate steatosis (p = 0.98). In multiple regression analysis, the most powerful predictors of elevated ALT, after correction for age, gender, BMI and pubertal status, were insulin resistance (p < 0.01) and MRI HFF (p < 0.0001).

Conclusions: Unlike sonography, an operator-dependent procedure, MRI is not subject to interpretation or inter-observer variation, and may be more useful than ultrasound for the monitoring of young patients with hepatic steatosis.

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