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1.
Eur Radiol ; 33(12): 8999-9009, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37402003

ABSTRACT

OBJECTIVE: To validate the proton density fat fraction (PDFF) obtained by the MRQuantif software from 2D chemical shift encoded MR (CSE-MR) data in comparison with the histological steatosis data. METHODS: This study, pooling data from 3 prospective studies spread over time between January 2007 and July 2020, analyzed 445 patients who underwent 2D CSE-MR and liver biopsy. MR derived liver iron concentration (MR-LIC) and PDFF was calculated using the MRQuantif software. The histological standard steatosis score (SS) served as reference. In order to get a value more comparable to PDFF, histomorphometry fat fraction (HFF) were centrally determined for 281 patients. Spearman correlation and the Bland and Altman method were used for comparison. RESULTS: Strong correlations were found between PDFF and SS (rs = 0.84, p < 0.001) or HFF (rs = 0.87, p < 0.001). Spearman's coefficients increased to 0.88 (n = 324) and 0.94 (n = 202) when selecting only the patients without liver iron overload. The Bland and Altman analysis between PDFF and HFF found a mean bias of 5.4% ± 5.7 [95% CI 4.7, 6.1]. The mean bias was 4.7% ± 3.7 [95% CI 4.2, 5.3] and 7.1% ± 8.8 [95% CI 5.2, 9.0] for the patients without and with liver iron overload, respectively. CONCLUSION: The PDFF obtained by MRQuantif from a 2D CSE-MR sequence is highly correlated with the steatosis score and very close to the fat fraction estimated by histomorphometry. Liver iron overload reduced the performance of steatosis quantification and joint quantification is recommended. This device-independent method can be particularly useful for multicenter studies. CLINICAL RELEVANCE STATEMENT: The quantification of liver steatosis using a vendor-neutral 2D chemical-shift MR sequence, processed by MRQuantif, is well correlated to steatosis score and histomorphometric fat fraction obtained from biopsy, whatever the magnetic field and the MR device used. KEY POINTS: • The PDFF measured by MRQuantif from 2D CSE-MR sequence data is highly correlated to hepatic steatosis. • Steatosis quantification performance is reduced in case of significant hepatic iron overload. • This vendor-neutral method may allow consistent estimation of PDFF in multicenter studies.


Subject(s)
Fatty Liver , Iron Overload , Non-alcoholic Fatty Liver Disease , Humans , Protons , Prospective Studies , Liver/diagnostic imaging , Liver/pathology , Magnetic Resonance Imaging/methods , Fatty Liver/diagnostic imaging , Fatty Liver/pathology , Iron Overload/diagnostic imaging , Non-alcoholic Fatty Liver Disease/diagnostic imaging , Non-alcoholic Fatty Liver Disease/pathology
2.
Eur J Obstet Gynecol Reprod Biol ; 252: 198-205, 2020 Sep.
Article in English | MEDLINE | ID: mdl-32622104

ABSTRACT

OBJECTIVE: To report complications of Acute Fatty Liver of pregnancy (AFLP), a rare liver disease of pregnancy, and identify prognostic factors for mothers and children. STUDY DESIGN: We conducted a retrospective descriptive study over 18 years in three French maternities. Demographic, clinical, biological data, and outcomes of patients and their infants were reviewed. RESULTS: 142,450 pregnancies from centers were studied. Eighteen patients with AFLP were identified The prevalence of AFLP was estimated as 1/7,914 pregnancies. Prolonged prothrombin time was identified as a risk factor of maternal complications (OR = 0.86, p = 0.0493). Gestational age at delivery was the only risk factor associated with fetal or neonate complications (OR = 0.37, p = 0.0417). One boy died of previously undiagnosed ß-oxidation deficiency at eight months. CONCLUSION: In AFLP, prothrombin time must be carefully monitored to anticipate major maternal complications. Infants born to mothers with ALFP should be screened as early as possible for mitochondrial fatty acid oxidation deficiency.


Subject(s)
Fatty Liver , Pregnancy Complications , Fatty Liver/epidemiology , Female , Humans , Infant, Newborn , Male , Pregnancy , Pregnancy Complications/epidemiology , Prognosis , Retrospective Studies
3.
Abdom Radiol (NY) ; 42(6): 1713-1720, 2017 06.
Article in English | MEDLINE | ID: mdl-28224171

ABSTRACT

PURPOSE: To evaluate the performance and limitations of the signal intensity ratio method for quantifying liver iron overload at 3 T. METHODS: Institutional review board approval and written informed consent from all participants were obtained. One hundred and five patients were included prospectively. All patients underwent a liver biopsy with biochemical assessment of hepatic iron concentration and a 3 T MRI scan with 5 breath-hold single-echo gradient-echo sequences. Linear correlation between liver-to-muscle signal intensity ratio and liver iron concentration was calculated. The algorithm for calculating magnetic resonance hepatic iron concentration was adapted from the method described by Gandon et al. with echo times divided by 2. Sensitivity and specificity were calculated. RESULTS: Five patients were excluded (coil selection failure or missing sequence) and 100 patients were analyzed, 64 men and 36 women, 52 ± 13.3 years old, with a biochemical hepatic iron concentration range of 0-630 µmol/g. Linear correlation between biochemical hepatic iron concentration and MR-hepatic iron concentration was excellent with a correlation coefficient = 0.96, p < 0.0001. Sensitivity and specificity were, respectively, 83% (0.70-0.92) and 96% (0.85-0.99), with a pathological threshold of 36 µmol/g. CONCLUSION: Signal intensity ratio method for quantifying liver iron overload can be used at 3 T with echo times divided by 2.


Subject(s)
Iron Overload/diagnostic imaging , Liver Diseases/diagnostic imaging , Magnetic Resonance Imaging/methods , Algorithms , Biopsy , Female , Humans , Male , Middle Aged , Sensitivity and Specificity
7.
Pathol Biol (Paris) ; 58(5): 316-23, 2010 Oct.
Article in French | MEDLINE | ID: mdl-19942367

ABSTRACT

The field of hereditary iron overload has known, in the recent period, deep changes mainly related to major advances in molecular biology. It encompasses now a series of genetic entities. The mechanistic understanding of iron overload development and iron toxicity has greatly improved. The diagnostic approach has become essentially noninvasive with a major role for biological tests. From the therapeutic viewpoint, the phlebotomy treatment is now enriched by the possibility of resorting to oral chelation and by innovative perspectives directly linked to our improvement in the molecular understanding of these diseases.


Subject(s)
Iron Overload/genetics , Antimicrobial Cationic Peptides/deficiency , Antimicrobial Cationic Peptides/genetics , Cation Transport Proteins/deficiency , Cation Transport Proteins/genetics , Ceruloplasmin/deficiency , Ceruloplasmin/genetics , Chelation Therapy , Forecasting , Genetic Counseling , Hemochromatosis/classification , Hemochromatosis/diagnosis , Hemochromatosis/drug therapy , Hemochromatosis/genetics , Hemochromatosis/therapy , Hemochromatosis Protein , Hemosiderosis/genetics , Hemosiderosis/metabolism , Hepcidins , Histocompatibility Antigens Class I/genetics , Humans , Iron/metabolism , Iron Metabolism Disorders/genetics , Iron Overload/diagnosis , Iron Overload/drug therapy , Iron Overload/physiopathology , Iron Overload/therapy , Liver/metabolism , Membrane Proteins/deficiency , Membrane Proteins/genetics , Molecular Diagnostic Techniques , Neurodegenerative Diseases/genetics , Phlebotomy
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