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Liver Steatosis: Investigation of Opposed-Phase T1-weighted Liver MR Signal Intensity Loss and Visceral Fat Measurement as Biomarkers¹

¹ From the Departments of Radiology (M.B., A.Q., A.C.W., S.M.N., P.W.C.), Pathology (L.F.), and Medicine (P.C.T., N.M.B., R.B.M.), University of California, San Francisco, Box 0628, L-307, 505 Parnassus Ave, San Francisco, CA 94143-0628. Received August 2, 2007; revision requested October 5; revision received March 3, 2008; final version accepted May 19. Funded in part by National Institute of Diabetes and Digestive and Kidney Diseases (supplement to RFA-DK-01-025). Study was part of the Women's Interagency HIV Study, funded by National Institute of Allergy and Infectious Diseases. Address correspondence to A.Q. (e-mail: Aliya.Qayyum{at}radiology.ucsf.edu).

Purpose: To investigate if opposed-phase T1-weighted and fat-suppressed T2-weighted liver signal intensity (SI) loss and visceral fat measurement at magnetic resonance (MR) imaging and body mass index (BMI) are correlated with grade of liver steatosis in patients with nonalcoholic fatty liver disease (NAFLD) or hepatitis C virus (HCV) and human immunodeficiency virus (HIV)–related liver disease.

Materials and Methods: Committee on Human Research approval and patient consent were obtained for this HIPAA-compliant study. Fifty-two patients (15 men, 37 women) with NAFLD (n = 29) or HCV and HIV–related liver disease (n = 23) underwent prospective contemporaneous MR imaging and liver biopsy. Liver SI loss was measured on opposed-phase T1-weighted and fat-suppressed T2-weighted MR images. Visceral fat area was measured at three levels on water-suppressed T1-weighted MR images (n = 44). Spearman rank correlation coefficients and recursive partitioning were used to examine correlations.

Results: Histopathologic liver steatosis correlated well with liver SI loss on opposed-phase T1-weighted MR images ( = 0.78), fat-suppressed T2-weighted MR images ( = 0.75), and average visceral fat area ( = 0.77) (all P < .01) but poorly with BMI ( = 0.53, P < .01). Liver SI losses on opposed-phase T1-weighted MR imaging of less than 3%, at least 3% but less than 35%, at least 35% but less than 49%, and at least 49% corresponded to histopathologic steatosis grades of 0 (n = 16 of 17), 1 (n = 11 of 16), 2 (n = 7 of 13), and 3 (n = 5 of 6), respectively. A visceral fat area of greater than or equal to 73.8 cm² was associated with the presence of histopathologic steatosis in 41 of 44 patients.

Conclusion: Liver SI loss on opposed-phase T1-weighted MR images and visceral fat area may be used as biomarkers for the presence of liver steatosis and appear to be superior to BMI.

© RSNA, 2008