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Updated: May 30, 2026
A 3D Quantification Technique for Liver Fat Fraction Distribution Analysis Using Dixon Magnetic Resonance Imaging
Published on: October 20, 2023
T1-weighted dual-echo MRI for fat quantification in pediatric nonalcoholic fatty liver disease
Lucia Pacifico1, Michele Di Martino, Carlo Catalano
1Department of Pediatrics, Sapienza University of Rome, Viale Regina Elena 324, 00161-Rome, Italy.
Insights
Magnetic resonance imaging (MRI) accurately assesses liver fat in obese children with nonalcoholic fatty liver disease (NAFLD). This non-invasive method shows high correlation with histological steatosis and can track changes with weight loss.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Hepatology
Background:
- Nonalcoholic fatty liver disease (NAFLD) is increasingly prevalent in obese children.
- Accurate assessment of liver fat is crucial for diagnosis and management.
- Liver biopsy, the gold standard, is invasive and carries risks.
Purpose of the Study:
- To evaluate the accuracy of magnetic resonance imaging (MRI) for quantifying liver fat in obese children diagnosed with NAFLD.
- To compare MRI-derived hepatic fat fraction (HFF) with histological findings.
Main Methods:
- A case-control study involving 25 obese children with biopsy-proven NAFLD and 25 matched obese controls.
- Hepatic fat fraction (HFF) was measured using MRI with a modified Dixon method.
- Comparison of HFF with histological grades of steatosis.
Main Results:
- HFF in children with NAFLD ranged from 2% to 44%, significantly higher than in controls (0.08% to 4.69%).
- HFF demonstrated a strong correlation with histological steatosis (r = 0.883, P < 0.0001).
- MRI achieved 95.8% sensitivity and 100% specificity for detecting histological steatosis ≥ 5% using a cutoff of 4.85%.
Conclusions:
- Magnetic resonance imaging (MRI) is a highly accurate non-invasive tool for quantifying liver fat in pediatric NAFLD.
- MRI can reliably differentiate between children with and without significant hepatic steatosis.
- Changes in HFF were observed following weight loss, suggesting MRI's utility in monitoring treatment response.
Aim:
To determine in obese children with nonalcoholic fatty liver disease (NAFLD) the accuracy of magnetic resonance imaging (MRI) in assessing liver fat concentration.
Methods:
A case-control study was performed. Cases were 25 obese children with biopsy-proven NAFLD. Controls were 25 obese children matched for age and gender, without NAFLD at ultrasonography and with normal levels of aminotransferases and insulin. Hepatic fat fraction (HFF) by MRI was obtained using a modification of the Dixon method.
Results:
HFF ranged from 2% to 44% [mean, 19.0% (95% CI, 15.1-27.4)] in children with NAFLD, while in the controls this value ranged from 0.08% to 4.69% [2.0% (1.3-2.5), P < 0.0001]. HFF was highly correlated with histological steatosis (r = 0.883, P < 0.0001) in the NAFLD children. According to the histological grade of steatosis, the mean HFF was 8.7% (95% CI, 6.0-11.6) for mild, 21.6% (15.3-27.0) for moderate, and 39.7% (34.4-45.0) for severe fatty liver infiltration. With a cutoff of 4.85%, HFF had a sensitivity of 95.8% for the diagnosis of histological steatosis ≥ 5%. All control children had HFF lower than 4.85%; thus, the specificity was 100%. After 12 mo, children with weight loss displayed a significant decrease in HFF.
Conclusion:
MRI is an accurate methodology for liver fat quantification in pediatric NAFLD.
