Hong Koh1, Seung Kim1, Myung-Joon Kim1, Hyun Gi Kim1, Hyun Joo Shin1, Mi-Jung Lee1. 1. Hong Koh, Seung Kim, Department of Pediatrics, Severance Pediatric Liver Disease Research Group, Severance Children's Hospital, Yonsei University College of Medicine, Seoul 120-752, South Korea.
Abstract
AIM: To evaluate the possibility of treatment effect monitoring using hepatic fat quantification magnetic resonance (MR) in pediatric nonalcoholic steatohepatitis (NASH). METHODS: We retrospectively reviewed the medical records of patients who received educational recommendations and vitamin E for NASH and underwent hepatic fat quantification MR from 2011 to 2013. Hepatic fat fraction (%) was measured using dual- and triple-echo gradient-recalled-echo sequences at 3T. The compliant and non-compliant groups were compared clinically, biochemically, and radiologically. RESULTS: Twenty seven patients (M:F = 24:3; mean age: 12 ± 2.3 years) were included (compliant group = 22, non-compliant = 5). None of the baseline findings differed between the 2 groups, except for triglyceride level (compliant vs non-compliant, 167.7 mg/dL vs 74.2 mg/dL, P = 0.001). In the compliant group, high-density lipoprotein increased and all other parameters decreased after 1-year follow-up. However, there were various changes in the non-compliant group. Dual-echo fat fraction (-19.2% vs 4.6, P < 0.001), triple-echo fat fraction (-13.4% vs 3.5, P < 0.001), alanine aminotransferase (-110.7 IU/L vs -10.6 IU/L, P = 0.047), total cholesterol (-18.1 mg/dL vs 3.8 mg/dL, P = 0.016), and triglyceride levels (-61.3 mg/dL vs 11.2 mg/dL, P = 0.013) were significantly decreased only in the compliant group. The change in body mass index and dual-echo fat fraction showed a positive correlation (ρ = 0.418, P = 0.030). CONCLUSION: Hepatic fat quantification MR can be a non-invasive, quantitative and useful tool for monitoring treatment effects in pediatric NASH.
AIM: To evaluate the possibility of treatment effect monitoring using hepatic fat quantification magnetic resonance (MR) in pediatric nonalcoholic steatohepatitis (NASH). METHODS: We retrospectively reviewed the medical records of patients who received educational recommendations and vitamin E for NASH and underwent hepatic fat quantification MR from 2011 to 2013. Hepatic fat fraction (%) was measured using dual- and triple-echo gradient-recalled-echo sequences at 3T. The compliant and non-compliant groups were compared clinically, biochemically, and radiologically. RESULTS: Twenty seven patients (M:F = 24:3; mean age: 12 ± 2.3 years) were included (compliant group = 22, non-compliant = 5). None of the baseline findings differed between the 2 groups, except for triglyceride level (compliant vs non-compliant, 167.7 mg/dL vs 74.2 mg/dL, P = 0.001). In the compliant group, high-density lipoprotein increased and all other parameters decreased after 1-year follow-up. However, there were various changes in the non-compliant group. Dual-echo fat fraction (-19.2% vs 4.6, P < 0.001), triple-echo fat fraction (-13.4% vs 3.5, P < 0.001), alanine aminotransferase (-110.7 IU/L vs -10.6 IU/L, P = 0.047), total cholesterol (-18.1 mg/dL vs 3.8 mg/dL, P = 0.016), and triglyceride levels (-61.3 mg/dL vs 11.2 mg/dL, P = 0.013) were significantly decreased only in the compliant group. The change in body mass index and dual-echo fat fraction showed a positive correlation (ρ = 0.418, P = 0.030). CONCLUSION: Hepatic fat quantification MR can be a non-invasive, quantitative and useful tool for monitoring treatment effects in pediatric NASH.
Authors: Lauren N Bell; Jiangxia Wang; Sriya Muralidharan; Sadhana Chalasani; Allison M Fullenkamp; Laura A Wilson; Arun J Sanyal; Kris V Kowdley; Brent A Neuschwander-Tetri; Elizabeth M Brunt; Arthur J McCullough; Nathan M Bass; Anna Mae Diehl; Aynur Unalp-Arida; Naga Chalasani Journal: Hepatology Date: 2012-08-21 Impact factor: 17.425
Authors: Hannah I Awai; Kimberly P Newton; Claude B Sirlin; Cynthia Behling; Jeffrey B Schwimmer Journal: Clin Gastroenterol Hepatol Date: 2013-09-30 Impact factor: 11.382
Authors: Sang Won Lee; Seong Ho Park; Kyoung Won Kim; Eugene K Choi; Yong Moon Shin; Pyo Nyun Kim; Kyoung Ho Lee; Eun Sil Yu; Shin Hwang; Sung-Gyu Lee Journal: Radiology Date: 2007-08 Impact factor: 11.105
Authors: Thuy-Anh Le; Joshua Chen; Christopher Changchien; Michael R Peterson; Yuko Kono; Heather Patton; Benjamin L Cohen; David Brenner; Claude Sirlin; Rohit Loomba Journal: Hepatology Date: 2012-07-02 Impact factor: 17.425