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BACKGROUND AND AIMS: The diagnosis of non-alcoholic steatohepatitis (NASH) and fibrosis staging are central to non-alcoholic fatty liver disease (NAFLD) assessment. We evaluated multi-parametric magnetic resonance (MR) in the assessment of NASH and fibrosis using histology as standard in NAFLD. METHODS: Seventy one patients with suspected NAFLD were recruited within one month of liver biopsy. MR data were used to define the liver inflammation and fibrosis score (LIF 0-4). Biopsies were assessed for steatosis, lobular inflammation, ballooning and fibrosis and classified as NASH or simple steatosis, and mild or significant (Activity ≥2 and / or Fibrosis ≥2 as defined by the Fatty Liver Inhibition of Progression consortium) NAFLD. Transient elastography (TE) was also performed. RESULTS: MR success rate was 95% vs 59% for TE (p<0.0001). Fibrosis stage on biopsy correlated with LIF (rs =0.51, p<0.0001). The area under the receiver operating curve (AUROC) using LIF for the diagnosis of cirrhosis was 0.85. LIF score for ballooning grades 0, 1 and 2 was 1.2, 2.7 and 3.5 respectively (p<0.05) with an AUROC of 0.83 for the diagnosis of ballooning. Patients with steatosis had lower LIF (1.3) compared to patients with NASH (3.0) (p<0.0001); AUROC for the diagnosis of NASH was 0.80. LIF scores for patients with mild and significant NAFLD were 1.2 and 2.9 respectively (p<0.0001). The AUROC of LIF for the diagnosis of significant NAFLD was 0.89. CONCLUSIONS: Multi-parametric MR is a promising technique with good diagnostic accuracy for NAFLD histological parameters, and can potentially identify patients with NASH and cirrhosis. This article is protected by copyright. All rights reserved.

Original publication




Journal article


Liver Int

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NASH, diagnostic accuracy, non-invasive test, sensitivity and specificity