Homogeneity of Liver Fat Distribution Serves as a Diagnostic Marker for Metabolic Dysfunction-Associated Steatohepatitis

IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology Pub Date : 2026-10-01 Epub Date: 2026-07-03 DOI:10.1016/j.acra.2026.06.016

Danfeng Yu MS, Da Fang PhD, Hailong Zhang MS, Tianwei Gu PhD, Wenhuan Feng PhD, Yan Bi PhD, Jun Chen PhD, Wenjuan Tang PhD

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引用次数: 0

Abstract

Rationale and Objectives

To characterize liver fat distribution in metabolic dysfunction-associated steatohepatitis (MASH) and propose a magnetic resonance imaging proton density fat fraction (MRI-PDFF)-based score for MASH identification in obesity.

Materials and Methods

Individuals with obesity were recruited for liver biopsy and contemporaneous MR scanning. The variability in fat distribution was evaluated by calculating the standard deviation (SD), range, and coefficient of variation of MRI-PDFF across liver lobes. A machine learning-assisted strategy was employed to establish a diagnostic model for MASH.

Results

A total of 107 participants with biopsy-confirmed fatty liver were included, and 44 were diagnosed with MASH. The MASH group exhibited significantly higher fat content in all liver segments and more homogeneous fat distribution in the right liver lobe than those with non-MASH. A raw-MASH score, incorporating the mean value and SD of PDFF in the right lobe, alanine aminotransferase levels, and waist circumference, was then established to identify MASH with an area under the receiver operating characteristic curve (AUROC) of 0.90 (95%CI 0.84–0.95). It performed better than HAIR, ION, and acNASH (all p < 0.05), and exhibited higher AUROC than MR-MASH model (0.90 vs. 0.85, p = 0.066). Besides, the dual threshold strategy of raw-MASH improved the diagnostic performance with high sensitivity and specificity.

Conclusion

In addition to the hepatic fat content, the homogeneity of fat distribution may represent another significant hallmark of MASH. The raw-MASH score, which is available from MR imaging and routine clinical collection, shows great potential for identifying MASH in obesity.

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查看原文本刊更多论文

肝脏脂肪分布的均匀性可作为代谢功能障碍相关脂肪性肝炎的诊断标志。

基本原理和目的：表征代谢功能障碍相关脂肪性肝炎（MASH）的肝脏脂肪分布，并提出基于磁共振成像质子密度脂肪分数（MRI-PDFF）的肥胖MASH识别评分。材料和方法：招募肥胖个体进行肝活检和同期磁共振扫描。通过计算肝叶MRI-PDFF的标准差（SD）、极差和变异系数来评估脂肪分布的可变性。采用机器学习辅助策略建立MASH诊断模型。结果：共纳入107例活检证实的脂肪肝患者，其中44例诊断为MASH。与非MASH组相比，MASH组肝各节脂肪含量显著增加，右肝叶脂肪分布更均匀。结合右叶PDFF的平均值和SD、丙氨酸转氨酶水平和腰围，建立了一个raw-MASH评分，以确定接受者工作特征曲线下面积（AUROC）为0.90 （95%CI 0.84-0.95）的MASH。该模型优于HAIR、ION和acNASH模型（p < 0.05）， AUROC高于MR-MASH模型（0.90比0.85,p = 0.066）。此外，raw-MASH的双阈值策略提高了诊断性能，具有较高的敏感性和特异性。结论：除了肝脏脂肪含量外，脂肪分布的均匀性可能是MASH的另一个重要标志。从磁共振成像和常规临床收集中获得的raw-MASH评分显示出在肥胖症中识别MASH的巨大潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Academic Radiology 医学-核医学

CiteScore

7.60

自引率

10.40%

发文量

432

审稿时长

18 days

期刊介绍： Academic Radiology publishes original reports of clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, image-guided interventions and related techniques. It also includes brief technical reports describing original observations, techniques, and instrumental developments; state-of-the-art reports on clinical issues, new technology and other topics of current medical importance; meta-analyses; scientific studies and opinions on radiologic education; and letters to the Editor.