Magnetic resonance imaging in the diagnosis of steatosis in metabolic-associated fatty liver disease in adolescents

Abstract

Incidence of overweight and obesity is increasing among the child population Worldwide. The prevalence of fatty liver disease is increasing as well. The transition to the new term “metabolically associated fatty liver disease” (MAFLD) implies the identification of hepatic steatosis and its quantitative assessment. Magnetic resonance imaging (MRI) has significant advantages for assessing hepatic steatosis, but is rarely used in pediatric practitioners’ routine. The purpose of this research was to improve the quality of MAFLD diagnosis in adolescents with obesity by identifying steatosis and liver fibrosis using MRI. Materials and methods used: 30 adolescents aged 12 to 17 y/o, 17 (56.7%) boys/13 (43.3%) girls, with obesity and diagnosed MAFLD were examined (MRI of the liver was performed with Philips Ingenia 1.5T). Results: hepatic steatosis was detected in 22 (73.3%). The percentage of liver fatty fraction was determined from 0.5% to 76%, the median was 25.50% [6.38; 38.75]. In accordance with the classification of steatosis by degree, S1 was determined in 12 (40.0%), S2 in 8 (26.7%) and S3 in 2 (7%). In 8 (26.7%) there was no steatosis (“S0”). Pancreatic steatosis was detected in 2 (6.7%). Liver steatosis was detected in the 1st degree obesity in 62.5%, in 83.3% in the 2nd degree, in 71.4% in the 3rd degree and in 77.8% in the 4th degree. All the three degrees of liver steatosis were diagnosed with a predominance of the 1st, which was determined in 40.0%, S2 in 26.7% and S3 in 7%. Conclusion: in obesity in adolescents with MAFLD and/or steatohepatitis, MRI reveals liver steatosis in 73.3% of patients. There was no difference (p=0.252) in the incidence of degrees of liver steatosis detected by MRI among different degrees of obesity. Dyslipidemia and insulin resistance were detected regardless of the presence and degree of liver steatosis. Since MRI is a non-invasive and informative method for examining children with MAFLD, it does allow rather more accurate assessment of the adipose tissue presence in the liver compared to a ‘routine’ ultrasound.