Abstract
Increased hepatic fat content (HFC) is a hallmark of non-alcoholic fatty liver (NAFL) disease, a common condition in liver transplant recipients. Proton MR spectroscopy (1H MRS) and MR imaging-based proton density fat fraction as the only diagnosis modality enable precise non-invasive measurement of HFC and, also, fatty acid profiles in vivo. Using 1H MRS at 3T, we examined 47 liver transplantation candidates and 101 liver graft recipients. A point-resolved spectroscopy sequence was used to calculate the steatosis grade along with the saturated, unsaturated and polyunsaturated fractions of fatty acids in the liver. The steatosis grade measured by MRS was compared with the histological steatosis grade. HFC, represented by fat fraction values, is adept at distinguishing non-alcoholic steatohepatitis (NASH), NAFL and non-steatotic liver transplant patients. Relative hepatic lipid saturation increases while unsaturation decreases in response to increased HFC. Additionally, relative hepatic lipid saturation increases while unsaturation and polyunsaturation both decrease in liver recipients with histologically proven post-transplant NASH or NAFL compared to non-steatotic patients. HFC, measured by in vivo 1H MRS, correlated well with histological results. 1H MRS is a simple and fast method for in vivo analysis of HFC and its composition. It provides non-invasive support for NAFL and NASH diagnoses.
Highlights
Non-alcoholic fatty liver disease (NAFLD), which results from excessive liver fat accumulation, is one of the most frequent liver diseases and is characterized by varying degrees of progression
Conditions range from liver steatosis [1], which can progress in some patients to non-alcoholic steatohepatitis (NASH) [2] characterized by inflammation and hepatocyte ballooning, to fibrosis, cirrhosis and/or hepatocellular carcinoma [3]
The aims of our study were to conduct a detailed analysis of liver fat metabolic profiles using Magnetic resonance (MR) spectroscopy (MRS) and to calculate the fractions of saturated, monounsaturated and polyunsaturated functional groups in fatty acid chains in relation to the presence of steatosis/steatohepatitis in patients before and after liver transplantation (LT)
Summary
Non-alcoholic fatty liver disease (NAFLD), which results from excessive liver fat accumulation (steatosis), is one of the most frequent liver diseases and is characterized by varying degrees of progression. Two of the most effective methods for steatosis measurement are the magnetic resonance imaging technique known as proton density fat fraction (PDFF) and MR spectroscopy (MRS) calculation of fatty acid fractions (FF). Both methods are commonly used in clinical practice to quantify HFC in patients with various liver diseases and to evaluate the effects of certain treatments, dietary interventions or exercise on hepatic steatosis [6,7,8]
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