Rev Esp Enferm Dig. 2022 Jul 6. doi: 10.17235/reed.2022.8777/2022. Online ahead of print.
ABSTRACT
OBJECTIVES: To evaluate the performance of magnetic resonance elastography (MRE) in staging liver fibrosis in patients with histologically confirmed nonalcoholic fatty liver disease (NAFLD) and to assess the impact of potential confounding factors in MRE diagnostic accuracy. Secondary objective was to compare MRE with other non-invasive methods for staging fibrosis such as transient elastography and non invasive scores(APRI and FIB-4) Methods: Sixty-five histologically confirmed NAFLD patients were prospectively enrolled at ‘Virgen del Rocío’ University Hospital (Seville). Liver stiffness was measured by MRE, transient elastography and non invasive scores(APRI and FIB-4). Fibrosis was assessed by liver biopsy using SAF score. We classified patients into 3 groups according to the consistency between MRE and histopathological findings: underestimation, concordance and overestimation group. Areas under the ROC curve (AUROC) and diagnostic performance were evaluated.
RESULTS: The area under the ROC curve (AUROC)of MRE in advanced fibrosis(≥F3) was 0.90[0.82-0.97], while transient elastography AUROC was 0.82[0.72-0.93](p=0.22) and lower for non-invasive test(FIB-4 0.67 and APRI 0.62). Inflammatory activity, steatosis grade and higher levels of liver biochemistry appeared to overestimate MRE results in univariate analysis, but only GGT was statistically significant in the multivariate analysis(p<0.01). Age, sex, BMI, weight, DM, HTA, platelets or lipidic profile did not affect MRE accuracy.
CONCLUSIONS: MRE is an effective and non-invasive method for detecting and staging liver fibrosis in NAFLD patients. MRE is more accurate than transient elastography and allows the study of liver anatomy. Histological inflammation and surrogate biomarkers of inflammation can overestimate liver stiffness, but only GGT was statistically significant in the multivariate analysis. Important features of NAFLD patients such as obesity, Mellitus diabetes, or lipidic profile did not affect MRE accuracy.
PMID:35791792 | DOI:10.17235/reed.2022.8777/2022
