Diagnosis of fatty liver with MR imaging
Burkhard P. Kreft MD
Department of Radiology, Massachusetts General Hospital, Boston
Search for more papers by this authorAkihiro Tanimoto MD
Department of Radiology, Massachusetts General Hospital, Boston
Search for more papers by this authorYuji Baba MD
Department of Radiology, Massachusetts General Hospital, Boston
Search for more papers by this authorLonghai Zhao MD
Department of Radiology, Massachusetts General Hospital, Boston
Search for more papers by this authorJohn Chen
Department of Radiology, Massachusetts General Hospital, Boston
Search for more papers by this authorMichael S. Middleton MD
Department of Radiology, University of California, San Diego
Search for more papers by this authorCarolyn C. Compton PhD, MD
Department of Pathology, Massachusetts General Hospital, Boston
Search for more papers by this authorJ. Paul Finn MD
Department of Radiology, New England Deaconess Hospital and Harvard Medical School, Boston
Search for more papers by this authorCorresponding Author
David D. Stark MD
Department of Radiology, Massachusetts General Hospital, Boston
University of Massachusetts Medical Center, 55 Lake Ave N, Worcester, MA 01605Search for more papers by this authorBurkhard P. Kreft MD
Department of Radiology, Massachusetts General Hospital, Boston
Search for more papers by this authorAkihiro Tanimoto MD
Department of Radiology, Massachusetts General Hospital, Boston
Search for more papers by this authorYuji Baba MD
Department of Radiology, Massachusetts General Hospital, Boston
Search for more papers by this authorLonghai Zhao MD
Department of Radiology, Massachusetts General Hospital, Boston
Search for more papers by this authorJohn Chen
Department of Radiology, Massachusetts General Hospital, Boston
Search for more papers by this authorMichael S. Middleton MD
Department of Radiology, University of California, San Diego
Search for more papers by this authorCarolyn C. Compton PhD, MD
Department of Pathology, Massachusetts General Hospital, Boston
Search for more papers by this authorJ. Paul Finn MD
Department of Radiology, New England Deaconess Hospital and Harvard Medical School, Boston
Search for more papers by this authorCorresponding Author
David D. Stark MD
Department of Radiology, Massachusetts General Hospital, Boston
University of Massachusetts Medical Center, 55 Lake Ave N, Worcester, MA 01605Search for more papers by this authorAbstract
The diagnosis of fatty liver with magnetic resonance (MR) imaging was evaluated in experimental rat models of simple fatty infiltration and fatty liver with hepatocellular injury. T1 and T2 were measured ex vivo and correlated with the histologic degree of fatty infiltration. Enhancement of fatty liver with four different cell-specific contrast agents was studied with ex vivo relaxometry and in vivo MR imaging. Quantitative analysis of conventional and chemical shift MR images was correlated with biochemically determined fat content of the liver. Diet-induced simple fatty infiltration of the liver caused a decrease in T1 of 15%, whereas the T1 of L-ethionine-induced fatty liver with hepatocellular injury increased by 12%. T2 showed a positive correlation with the degree of fatty infiltration in both models. Cell-specific hepatobiliary contrast agents showed the same liver uptake and relaxation enhancement in fatty livers as in normal livers. Conventional T1-weighted images and chemical shift images showed good correlation (r =.83 and.80, respectively) between signal intensity and the degree of fatty infiltration. However, only chemical shift imaging was reliable in the diagnosis of fatty liver.
References
- 1 Stark DD, Bass NM, Moss AA, et al. Nuclear magnetic resonance imaging of experimentally induced liver disease. Radiology 1983; 148: 743–751.
- 2 Stark DD, Goldberg HI, Moss AA, et al. Chronic liver disease: evaluation by magnetic resonance. Radiology 1984; 150: 149–151.
- 3 Alpers DH, Sabesin SM. Fatty liver: biochemical and clinical aspects. In: L Schiff, SchiffER, eds. Liver diseases. 5th ed. Philadelphia: Lippincott, 1982; 813–845.
- 4 Leevy CM. Fatty liver: a study of 270 patients with biopsy proven fatty liver and a review of the literature. Medicine 1962; 41: 249–276.
- 5 Devenyi P, Rutherdale J, Sereny G, et al. Clinical diagnosis of alcoholic fatty liver: Am J Gastroenterol 1970; 54: 597–602.
- 6 Scott WW Jr, Sanders R, Siegelman SS. Irregular fatty infiltration of the liver: a diagnostic dilemma. AJR 1980; 135: 67–71.
- 7 The Clinical NMR Group. Magnetic resonance imaging of parenchymal liver disease: a comparison with ultrasound, radionuclide scintigraphy and x-ray computed tomography. Clin Radiol 1987; 38: 495–502.
- 8 Needleman L, Kurtz AB, Rifkin MD, et al. Sonography of diffuse benign liver disease: accuracy pattern, recognition and grading. AJR 1986; 146: 1011–1015.
- 9 Quinn SF, Gosink BB. Characteristic sonographic signs of hepatic fatty infiltration. AJR 1985; 145: 753–755.
- 10 Bydder GM, Kreel L, Chapman RWG, et al. Accuracy of computed tomography in diagnosis of fatty liver. Br Med J 1980; 281–1042.
- 11 Ducommun JC, Goldberg HI, Korobkin M, et al. The relation of liver fat to computed tomography numbers: a preliminary experimental study in rabbits. Radiology 1979; 130: 511–513.
- 12 Kawata R, Sakata K, Kunieda T, et al. Quantitative evaluation of fatty liver by computed tomography in rabbits. AJR 1984; 142: 741–746.
- 13 Fantazzini P, Lendinara L, Novello F. Variations of the 1H spin-lattice relaxation in a fatty liver model as compared to normal liver. Magn Reson Imaging 1989; 7: 343–350.
- 14 Reimer P, Weissleder R, Lee AS, et al. Asialoglycoprotein receptor function in benign liver disease: evaluation with MR imaging. Radiology 1991; 178: 769–774.
- 15 Heiken JP, Lee JKT, Dixon WT. Fatty infiltration of the liver: evaluation by proton spectroscopic imaging. Radiology 1985; 157: 707–710.
- 16 Levenson H, Greensite F, Hoefs J, et al. Fatty infiltration of the liver: quantification with phase-contrast MR imaging at 1.5 T vs biopsy. AJR 1991; 156: 307–312.
- 17 Rosen BR, Carter EA, Pykett IL, et al. Proton chemical shift imaging: an evaluation of its clinical potential using an in vivo fatty liver model. Radiology 1985; 154: 469–472.
- 18 Pavone P, Patrizio G, Buoni C, et al. Comparison of Gd-BOPTA with Gd-DTPA in MR imaging of rat liver. Radiology 1990; 176: 61–64.
- 19 Cavagna F, Tirone P, Felder E, et al. Hepatobiliary contrast agents for MRI. In: J Ferrucci, DD Stark, eds. Liver imaging: current trends and new techniques. Boston: An-dover Medical, 1990; 384–393.
- 20 Elizondo G, Fretz C, Stark DD, et al. Preclinical evaluation of MnDPDP: new paramagnetic hepatobiliary contrast agent for MR imaging. Radiology 1991; 178: 73–78.
- 21 Lim KO, Stark DD, Leese PT, et al. Hepatobiliary MR imaging: first human experience with MnDPDP. Radiology 1991; 178: 79–82.
- 22 Josephson L, Lewis J, Jacobs P, et al. The effects of iron oxides on proton relaxivity. Magn Reson Imaging 1988; 6: 647–653.
- 23 Saini S, Stark DD, Hahn PF, et al. Ferrite particles: a su-perparamagnetic MR contrast agent for the reticuloendo-thelial system. Radiology 1987; 162: 211–216.
- 24 Stark DD, Weissleder R, Elizondo G, et al. Superpara-magnetic iron oxide: clinical application as a contrast agent for MR imaging of the liver. Radiology 1988; 168: 297–301.
- 25 Josephson L, Groman E, Menz L, et al. A functionalized superparamagnetic oxide colloid as a receptor-directed MR contrast agent. Magn Reson Imaging 1990; 8: 637–646.
- 26 Standerfer SB, Handler P. Fatty liver induced by orotic acid feeding. Proc Soc Exp Biol Med 1955; 90: 270–271.
- 27 Sidransky H. Sex difference in induction of fatty liver in the rat by dietary orotic acid. Endocrinology 1963; 72: 709–714.
- 28 Creasey WA, Hankin L, Handschuhmacher RE. Fatty liver induced by orotic acid. J Biol Chem 1961; 236: 2064–2070.
- 29 Novikoff PM, Edelstein D. Reversal of orotic acid induced fatty liver in rats by clofibrate. Lab Invest 1977; 36: 215–231.
- 30 Jatlow P, Adams WR, Handschuhmacher RE. Pathogene-sis of orotic acid induced fatty change in the liver. Am J Pathol 1965; 47: 125–145.
- 31 Farber E, Simpson MV, Tarver H. Studies on ethionine. II. The interference with lipid metabolism. J Biol Chem 1950; 182: 91–99.
- 32 Farber E, Koch-Weser D, Popper H. The influence of sex and of testosterone upon fatty liver due to ethionine. Endocrinology 1951; 48: 205–211.
- 33 Jensen D, Chaikoff IL, Tarver H. The ethionine induced fatty liver: dosage, prevention, and structural specificity. J Biol Chem 1951; 192: 395–403.
- 34 Hutterer F, Fitschen W, Popper H. Mitochondrial damage and hepatic steatosis in ethionine intoxication. Br J Exp Pathol 1961; 42: 187–193.
- 35 Bergmeyer HU, Bowers GN, Horder M, et al. Provisional recommendations on IFCC methods for the measurement of catalytic concentrations of enzymes. Clin Chem 1977; 23: 887–899.
- 36 Eggstein M, Kreutz FH. Eine neue bestimmung der neu-tralfette in blutserum und gewebe. II. Mitteilung uber zu-verlassigkeit der methode, andere neutralfettbestimmun-gen, normalwerte fur triglyceride und glycerin im menschlichen blut. Klin Wochenschr 1966; 44: 267–273.
- 37 Dixon WT. Simple proton spectroscopic imaging. Radiology 1984; 153: 189–194.
- 38 Zar JH. Biostatistical analysis. Englewood Cliffs, NJ: Prentice Hall, 1974; 121–129.
- 39 Ratner AV, Carter EA, Pohost GM, et al. Nuclear magnetic resonance spectroscopy and imaging in the study of experimental liver diseases. Alcoholism 1986; 10: 241–245.
- 40 Jacobs DO, Settle RG, Trerotola SO, et al. Detection of total parenteral nutrition-induced fatty liver infiltration in the rat by in vitro proton nuclear magnetic resonance. J Parenter Enteral Nutr 1986; 10: 177–183.
- 41 Jacobs DO, Trerotola SO, Settle RG, et al. In vitro detection of fatty liver infiltration in protein-depleted rats using proton nuclear magnetic resonance. J Surg Res 1985; 39: 25–30.
- 42 Bottomley PA, Foster TH, Argersinger RE, et al. A review of normal tissue hydrogen NMR relaxation times and mechanism from 1–100 MHz: dependence on tissue type. NMR frequency, temperature, species, excision, and age. Med Phys 1984; 11: 425–448.
- 43 Young IR. Special pulse sequences and techniques. In: DD Stark, WG Bradley, eds. Magnetic resonance imaging. St Louis: Mosby, 1988; 84–107.
- 44 Wenker JC, Baker MK, Ellis JH, et al. Focal fatty infiltration of the liver: demonstration by magnetic resonance imaging. AJR 1984; 143: 573–574.
- 45 Pope C, Gore CJ, Sostman D, et al. Diffuse fatty infiltration of the liver by magnetic resonance. Magn Reson Imaging 1986; 4: 267–270.
- 46 Schertz LD, Lee JKT, Heiken JP, et al. Proton spectroscopic imaging (Dixon method) of the liver: clinical utility. Radiology 1989; 173: 401–405.
- 47 Stark DD, Wittenberg J, Middleton MS, et al. Liver me-tastases: detection by phase-contrast MR imaging. Radiology 1986; 158: 327–332.
- 48 Keller PJ, Hunter WW Jr, Schmalbrock P. Multisection fat-water imaging with chemical shift selective presatura-tion. Radiology 1987; 164: 539–541.
- 49 Thoeni RF, Gorczyca DP, de Marco R. Fat saturation versus spin echo imaging for focal liver disease (abstr). In: Book of abstracts: Society of Magnetic Resonance in Medicine 1991. Berkeley, Calif: Society of Magnetic Resonance in Medicine, 1991: 97.
