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Normal range of hepatic fat fraction on dual- and triple-echo fat quantification MR in children
Hyun Joo Shin1, Hyun Gi Kim1, Myung-Joon Kim1
1Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
Insights
Hepatic fat fraction measurements using dual- and triple-echo MRI sequences in children showed no significant differences. A 6% hepatic fat fraction cutoff is recommended for diagnosing fatty liver in pediatric patients.
Area of Science:
- Radiology
- Pediatric Imaging
- Hepatology
Background:
- Non-alcoholic fatty liver disease (NAFLD) is a growing concern in children.
- Accurate assessment of hepatic fat fraction is crucial for diagnosis and management.
- Magnetic Resonance Imaging (MRI) offers a non-invasive method for quantifying liver fat.
Purpose of the Study:
- To compare hepatic fat fraction measurements between dual-echo and triple-echo gradient-recalled echo MRI sequences in healthy children.
- To evaluate the agreement between these two MRI techniques.
- To determine an appropriate cutoff value for diagnosing fatty liver in pediatric populations.
Main Methods:
- Retrospective review of 54 healthy children (aged 5-15 years) who underwent 3T MRI.
- Hepatic fat fraction was measured using both dual- and triple-echo sequences.
- Statistical analysis included Wilcoxon signed rank test, Bland-Altman analysis, and Spearman's correlation test.
Main Results:
- No significant difference was found between dual-echo (median 1.6%) and triple-echo (median 2.7%) hepatic fat fractions (p=0.010).
- Good agreement was observed between the two methods (Bland-Altman: -0.6 ± 2.8%).
- A hepatic fat fraction cutoff of 6% identified fewer children with fatty liver (3.7%) compared to other thresholds, with no significant correlation to clinical or laboratory findings.
Conclusions:
- Dual-echo and triple-echo MRI sequences provide comparable measurements of hepatic fat fraction in children.
- A cutoff value of 6% hepatic fat fraction is suggested as appropriate for diagnosing fatty liver in children using either sequence.
- These findings support the use of dual-echo sequences for efficient pediatric liver fat assessment.
Objectives:
To evaluate hepatic fat fraction on dual- and triple-echo gradient-recalled echo MRI sequences in healthy children.
Materials And Methods:
We retrospectively reviewed the records of children in a medical check-up clinic from May 2012 to November 2013. We excluded children with abnormal laboratory findings or those who were overweight. Hepatic fat fraction was measured on dual- and triple-echo sequences using 3T MRI. We compared fat fractions using the Wilcoxon signed rank test and the Bland-Altman 95% limits of agreement. The correlation between fat fractions and clinical and laboratory findings was evaluated using Spearman's correlation test, and the cut-off values of fat fractions for diagnosing fatty liver were obtained from reference intervals.
Results:
In 54 children (M:F = 26:28; 5-15 years; mean 9 years), the dual fat fraction (0.1-8.0%; median 1.6%) was not different from the triple fat fraction (0.4-6.5%; median 2.7%) (p = 0.010). The dual- and triple-echo fat fractions showed good agreement using a Bland-Altman plot (-0.6 ± 2.8%). Eight children (14.8%) on dual-echo sequences and six (11.1%) on triple-echo sequences had greater than 5% fat fraction. From these children, six out of eight children on dual-echo sequences and four out of six children on triple-echo sequences had a 5-6% hepatic fat fraction. When using a cut-off value of a 6% fat fraction derived from a reference interval, only 3.7% of children were diagnosed with fatty liver. There was no significant correlation between clinical and laboratory findings with dual and triple-echo fat fractions.
Conclusions:
Dual fat fraction was not different from triple fat fraction. We suggest a cut-off value of a 6% fat fraction is more appropriate for diagnosing fatty liver on both dual- and triple-echo sequences in children.
