Hepatic fat-content assessment using magnetic resonance-based methods

Imaging in Medicine

Volumn 3, Issue 2, 2011, Pages 193-206

  Bohte, Anneloes E ^a   Nederveen, Aart J ^a   Stoker, Jaap ^a  

^a UNIVERSITY OF AMSTERDAM   (Netherlands)

Author keywords

diagnostic accuracy; hepatic steatosis; liver; magnetic resonance spectroscopy; MRI

Indexed keywords

FAT; WATER;

BODY FAT; COMPUTER ASSISTED TOMOGRAPHY; DIAGNOSTIC TEST ACCURACY STUDY; FAT CONTENT; FATTY LIVER; FOLLOW UP; HEPATITIS C; HUMAN; IONIZING RADIATION; LIVER; LIVER BIOPSY; LIVER FAT; LIVER FIBROSIS; NONALCOHOLIC FATTY LIVER; NUCLEAR MAGNETIC RESONANCE IMAGING; PRIORITY JOURNAL; PROTON NUCLEAR MAGNETIC RESONANCE; REVIEW; ULTRASOUND;

EID: 79955099178     PISSN: 17555191     EISSN: 17555205     Source Type: Journal    
DOI: 10.2217/iim.11.13     Document Type: Review

References (107)

1. Bellentani S, Bedogni G, Miglioli L, Tiribelli C: The epidemiology of fatty liver. Eur. J. Gastroenterol. Hepatol. 16(11), 1087-1093 (2004). (Pubitemid 39488777)
2. Browning JD, Szczepaniak LS, Dobbins R et al.: Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity. Hepatology 40(6), 1387-1395 (2004). (Pubitemid 39657013)
3. Szczepaniak LS, Nurenberg P, Leonard D et al.: Magnetic resonance spectroscopy to measure hepatic triglyceride content: prevalence of hepatic steatosis in the general population. Am. J. Physiol. Endocrinol. Metab. 288(2), E462-E468 (2005). (Pubitemid 40110657)
4. Williams CD, Stengel J, Asike MI et al.: Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterology 140(1), 124-131 (2011).
5. Ratziu V, Bellentani S, Cortez-Pinto H, Day C, Marchesini G: A position statement on NAFLD/NASH based on the EASL 2009 special conference. J. Hepatol. 53(2), 372-384 (2010).
6. Vetelainen R, van VA, Gouma DJ, van Gulik TM: Steatosis as a risk factor in liver surgery. Ann. Surg. 245(1), 20-30 (2007). (Pubitemid 46035431)
7. Stepanova M, Rafiq N, Younossi ZM: Components of metabolic syndrome are independent predictors of mortality in patients with chronic liver disease: a population-based study. Gut 59(10), 1410-1415 (2010).
8. Angulo P: Nonalcoholic fatty liver disease. N. Engl. J. Med. 346(16), 1221-1231 (2002).
9. Hamer OW, Aguirre DA, Casola G, Lavine JE, Woenckhaus M, Sirlin CB: Fatty liver: imaging patterns and pitfalls. Radiographics 26(6), 1637-1653 (2006).
10. Brunt EM: Alcoholic and nonalcoholic steatohepatitis. Clin. Liver Dis. 6(2), 399-420, vii (2002). (Pubitemid 34755899)
11. Wong VW, Wong GL, Choi PC et al.: Disease progression of non-alcoholic fatty liver disease: a prospective study with paired liver biopsies at 3 years. Gut 59(7), 969-974 (2010).
12. Cobbold JF, Patel JH, Goldin RD et al.: Hepatic lipid profiling in chronic hepatitis C: an in vitro and in vivo proton magnetic resonance spectroscopy study. J. Hepatol. 52(1), 16-24 (2010).
13. Iwasaki M, Takada Y, Hayashi M et al.: Noninvasive evaluation of graft steatosis in living donor liver transplantation. Transplantation 78(10), 1501-1505 (2004). (Pubitemid 39552937)
14. Kim DY, Park SH, Lee SS et al.: Contrast-enhanced computed tomography for the diagnosis of fatty liver: prospective study with same-day biopsy used as the reference standard. Eur. Radiol. 20(2), 359-366 (2009).
15. Ploeg RJ, D'Alessandro AM, Knechtle SJ et al.: Risk factors for primary dysfunction after liver transplantation - a multivariate analysis. Transplantation 55(4), 807-813 (1993). (Pubitemid 23122053)
16. Yamashiki N, Sugawara Y, Tamura S et al.: Noninvasive estimation of hepatic steatosis in living liver donors: usefulness of visceral fat area measurement. Transplantation 88(4), 575-581 (2009).
17. Cadranel JF, Rufat P, Degos F: Practices of liver biopsy in France: results of a prospective nationwide survey. For the Group of Epidemiology of the French Association for the Study of the Liver (AFEF).Hepatology 32(3), 477-481 (2000).
18. Poynard T, Ratziu V, Bedossa P: Appropriateness of liver biopsy. Can. J. Gastroenterol. 14(6), 543-548 (2000). (Pubitemid 30447225)
19. Bravo AA, Sheth SG, Chopra S: Liver biopsy. N. Engl. J. Med. 344(7), 495-500 (2001). (Pubitemid 32164902)
20. Bohte AE, Van Werven JR, Bipat S, Stoker J: The diagnostic accuracy of US, CT, MRI and 1H-MRS for the evaluation of hepatic steatosis compared with liver biopsy: a meta-analysis. Eur. Radiol. 21(1), 87-97 (2011).
21. Lee SS, Park SH, Kim HJ et al.: Non-invasive assessment of hepatic steatosis: prospective comparison of the accuracy of imaging examinations. J. Hepatol. 52(4), 579-585 (2010).
22. Van Werven JR, Marsman HA, Nederveen AJ et al.: Assessment of hepatic steatosis in patients undergoing liver resection: comparison of US, CT, T1-weighted dual-echo MR imaging, and point-resolved 1H MR spectroscopy. Radiology 256(1), 159-168 (2010).
23. Borra RJ, Salo S, Dean K et al.: Nonalcoholic fatty liver disease: rapid evaluation of liver fat content with in-phase and out-of-phase MR imaging. Radiology 250(1), 130-136 (2009).
24. Gastaldelli A, Harrison S, Belfort-Aguiar R et al.: Pioglitazone in the treatment of NASH: the role of adiponectin. Aliment. Pharmacol. Ther. 32(6), 769-775 (2010).
25. Guiu B, Loffroy R, Petit JM et al.: Mapping of liver fat with triple-echo gradient echo imaging: validation against 3.0-T proton MR spectroscopy. Eur. Radiol. 19(7), 1786-1793 (2009).
26. Guiu B, Petit JM, Loffroy R et al.: Quantification of liver fat content: comparison of triple-echo chemical shift gradient-echo imaging and in vivo proton MR spectroscopy. Radiology 250(1), 95-102 (2009).
27. Guiu B, Petit JM, Loffroy R et al.: Liver methylene fraction by dual- and triple-echo gradient-echo imaging at 3.0T: correlation with proton MR spectroscopy and estimation of robustness after SPIO administration. J. Magn Reson. Imaging 33(1), 119-127 (2011).
28. Irwan R, Edens MA, Sijens PE: Assessment of the variations in fat content in normal liver using a fast MR imaging method in comparison with results obtained by spectroscopic imaging. Eur. Radiol. 18(4), 806-813 (2008).
29. Jonker JT, Wang Y, de HW et al.: Pioglitazone decreases plasma cholesteryl ester transfer protein mass, associated with a decrease in hepatic triglyceride content, in patients with Type 2 diabetes. Diabetes Care 33(7), 1625-1628 (2010).
30. Kim H, Taksali SE, Dufour S et al.: Comparative MR study of hepatic fat quantification using single-voxel proton spectroscopy, two-point dixon and three-point IDEAL. Magn. Reson. Med. 59(3), 521-527 (2008). (Pubitemid 351348223)
31. Kotronen A, Peltonen M, Hakkarainen A et al.: Prediction of non-alcoholic fatty liver disease and liver fat using metabolic and genetic factors. Gastroenterology 137(3), 865-872 (2009).
32. 2*: simultaneous measurement by using breath-hold multiecho MR imaging at 3.0 T - feasibility. Radiology 247(2), 550-557 (2008).
33. Schwimmer JB, Middleton MS, Deutsch R, Lavine JE: A Phase 2 clinical trial of metformin as a treatment for non-diabetic paediatric non-alcoholic steatohepatitis. Aliment. Pharmacol. Ther. 21(7), 871-879 (2005). (Pubitemid 40477247)
34. Visser ME, Akdim F, Tribble DL et al.: Effect of apolipoprotein-B synthesis inhibition on liver triglyceride content in patients with familial hypercholesterolemia. J. Lipid Res. 51(5), 1057-1062 (2010).
35. Yokoo T, Shiehmorteza M, Hamilton G et al.: Estimation of hepatic proton-density fat fraction by using MR imaging at 3.0 T. Radiology 258(3), 749-759 (2011).
36. Dixon WT: Simple proton spectroscopic imaging. Radiology 153(1), 189-194 (1984). (Pubitemid 14043406)
37. Salibi N, Brown MA: Clinical MR Spectroscopy: First Principles. Wiley-Liss, Inc., NJ, USA (1998).
38. Hughes Cassidy F, Yokoo T, Aganovic L et al.: Fatty liver disease: MR imaging techniques for the detection and quantification of liver steatosis. Radiographics 29(1), 231-260 (2009).
39. Sirlin CB: Noninvasive imaging biomarkers for steatosis assessment. Liver Transpl. 15(11), 1389-1391 (2009).
40. Reeder SB , Sirlin CB: Quantification of liver fat with magnetic resonance imaging. Magn Reson. Imaging Clin. N. Am. 18(3), 337-57 (2010).
41. Hussain HK, Chenevert TL, Londy FJ et al.: Hepatic fat fraction: MR imaging for quantitative measurement and display - early experience. Radiology 237(3), 1048-1055 (2005). (Pubitemid 41636400)
42. Qayyum A, Goh JS, Kakar S, Yeh BM, Merriman RB, Coakley FV: Accuracy of liver fat quantification at MR imaging: comparison of out-of-phase gradient-echo and fat-saturated fast spin-echo techniques - initial experience. Radiology 237(2), 507-511 (2005). (Pubitemid 41507887)
43. Reeder SB, Pineda AR, Wen Z et al.: Iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL): application with fast spin-echo imaging. Magn. Reson. Med. 54(3), 636-644 (2005). (Pubitemid 41233758)
44. Westphalen AC, Qayyum A, Yeh BM et al.: Liver fat: effect of hepatic iron deposition on evaluation with opposed-phase MR imaging. Radiology 242(2), 450-455 (2007). (Pubitemid 46146198)
45. Bydder M, Yokoo T, Hamilton G et al.: Relaxation effects in the quantification of fat using gradient echo imaging. Magn. Reson. Imaging 26(3), 347-359 (2008).
46. D'Assignies G, Ruel M, Khiat A et al.: Noninvasive quantitation of human liver steatosis using magnetic resonance and bioassay methods. Eur. Radiol. 19(8), 2033-2040 (2009).
47. Yokoo T, Bydder M, Hamilton G et al.: Nonalcoholic fatty liver disease: diagnostic and fat-grading accuracy of low-flip-angle multiecho gradient-recalled-echo MR imaging at 1.5 T. Radiology 251(1), 67-76 (2009).
48. Reeder SB, Robson PM, Yu H et al.: Quantification of hepatic steatosis with MRI: the effects of accurate fat spectral modeling. J. Magn. Reson. Imaging 29(6), 1332-1339 (2009).
49. Hamilton G, Yokoo T, Bydder M et al.: In vivo characterization of the liver fat 1H MR spectrum. NMR Biomed. DOI: 10.1002/nbm.1622 (2010) (Epub ahead of print).
50. Longo R, Pollesello P, Ricci C et al.: Proton MR spectroscopy in quantitative in vivo determination of fat content in human liver steatosis. J. Magn. Reson. Imaging 5(3), 281-285 (1995).
51. Hines CD, Yu H, Shimakawa A et al.: Quantification of hepatic steatosis with 3-T MR imaging: validation in ob/ob mice. Radiology 254(1), 119-128 (2010).
52. Liu CY, McKenzie CA, Yu H, Brittain JH, Reeder SB: Fat quantification with IDEAL gradient echo imaging: correction of bias from T1 and noise. Magn. Reson. Med. 58(2), 354-364 (2007). (Pubitemid 47267653)
53. Reeder SB, McKenzie CA, Pineda AR et al.: Water-fat separation with IDEAL gradient-echo imaging. J. Magn. Reson. Imaging 25(3), 644-652 (2007). (Pubitemid 46355429)
54. 2*estimation. J. Magn. Reson. Imaging 26(4), 1153-1161 (2007). (Pubitemid 47548182)
55. Bley TA, Wieben O, Francois CJ, Brittain JH, Reeder SB: Fat and water magnetic resonance imaging. J. Magn. Reson. Imaging 31(1), 4-18 (2010).
56. Cotler SJ, Guzman G, Layden-Almer J, Mazzone T, Layden TJ, Zhou XJ: Measurement of liver fat content using selective saturation at 3.0 T. J. Magn. Reson. Imaging 25(4), 743-748 (2007). (Pubitemid 46516726)
57. Cowin GJ, Jonsson JR, Bauer JD et al.: Magnetic resonance imaging and spectroscopy for monitoring liver steatosis. J. Magn. Reson. Imaging 28(4), 937-945 (2008).
58. McPherson S, Jonsson JR, Cowin GJ et al.: Magnetic resonance imaging and spectroscopy accurately estimate the severity of steatosis provided the stage of fibrosis is considered. J. Hepatol. 51(2), 389-397 (2009).
59. Bahl M, Qayyum A, Westphalen AC et al.: Liver steatosis: investigation of opposed-phase T1-weighted liver MR signal intensity loss and visceral fat measurement as biomarkers. Radiology 249(1), 160-166 (2008).
60. Delfaut EM, Beltran J, Johnson G, Rousseau J, Marchandise X, Cotten A: Fat suppression in MR imaging: techniques and pitfalls. Radiographics 19(2), 373-382 (1999).
61. Longo R, Ricci C, Masutti F et al.: Fatty infiltration of the liver. Quantification by 1H localized magnetic resonance spectroscopy and comparison with computed tomography. Invest. Radiol. 28(4), 297-302 (1993). (Pubitemid 24079682)
62. Angus PW, Dixon RM, Rajagopalan B et al.: A study of patients with alcoholic liver disease by 31P nuclear magnetic resonance spectroscopy. Clin. Sci. 78(1), 33-38 (1990). (Pubitemid 20030048)
63. Sevastianova K, Hakkarainen A, Kotronen A et al.: Nonalcoholic fatty liver disease: detection of elevated nicotinamide adenine dinucleotide phosphate with in vivo 3.0-T 31P MR spectroscopy with proton decoupling. Radiology 256(2), 466-473 (2010).
64. Petersen KF, West AB, Reuben A, Rothman DL, Shulman GI: Noninvasive assessment of hepatic triglyceride content in humans with 13C nuclear magnetic resonance spectroscopy. Hepatology 24(1), 114-117 (1996). (Pubitemid 26249421)
65. Friedrich-Rust M, Muller C, Winckler A et al.: Assessment of liver fibrosis and steatosis in PBC with fibroscan, MRI, MR-spectroscopy, and serum markers. J. Clin. Gastroenterol. 44(1), 58-65 (2009).
66. Krssak M, Hofer H, Wrba F et al.: Non-invasive assessment of hepatic fat accumulation in chronic hepatitis C by 1H magnetic resonance spectroscopy. Eur. J. Radiol. 74(3), e60-e66 (2009).
67. Orlacchio A, Bolacchi F, Cadioli M et al.: Evaluation of the severity of chronic hepatitis C with 3-T 1H-MR spectroscopy. AJR Am. J. Roentgenol. 190(5), 1331-1339 (2008). (Pubitemid 351684909)
68. Orlacchio A, Bolacchi F, Angelico M et al.: In vivo, high-field, 3-Tesla 1H MR spectroscopic assessment of liver fibrosis in HCV-correlated chronic liver disease. Radiol. Med. 113(2), 289-299 (2008). (Pubitemid 351666947)
69. Ma X, Holalkere NS, Kambadakone RA, Mino-Kenudson M, Hahn PF, Sahani DV: Imaging-based quantification of hepatic fat: methods and clinical applications. Radiographics 29(5), 1253-1277 (2009).
70. Bredella MA, Ghomi RH, Thomas BJ et al.: Breath-hold 1H-magnetic resonance spectroscopy for intrahepatic lipid quantification at 3 Tesla. J. Comput. Assist. Tomogr. 34(3), 372-376 (2010).
71. Van Werven JR, Hoogduin JM, Nederveen AJ et al.: Reproducibility of 3.0 Tesla magnetic resonance spectroscopy for measuring hepatic fat content. J. Magn Reson. Imaging 30(2), 444-448 (2009).
72. Qayyum A: MR spectroscopy of the liver: principles and clinical applications. Radiographics 29(6), 1653-1664 (2009).
73. Thomsen C, Becker U, Winkler K, Christoffersen P, Jensen M, Henriksen O: Quantification of liver fat using magnetic resonance spectroscopy. Magn. Reson. Imaging 12(3), 487-495 (1994). (Pubitemid 24113193)
74. Hamilton G, Middleton MS, Bydder M et al.: Effect of PRESS and STEAM sequences on magnetic resonance spectroscopic liver fat quantification. J. Magn. Reson. Imaging 30(1), 145-152 (2009).
75. Oostendorp M, Engelke UF, Willemsen MA, Wevers RA: Diagnosing inborn errors of lipid metabolism with proton nuclear magnetic resonance spectroscopy. Clin. Chem. 52(7), 1395-1405 (2006). (Pubitemid 43956033)
76. Stables LA, Kennan RP, Anderson AW, Gore JC: Density matrix simulations of the effects of J coupling in spin echo and fast spin echo imaging. J. Magn. Reson. 140(2), 305-314 (1999). (Pubitemid 129608295)
77. Fischbach F , Bruhn H: Assessment of in vivo 1H magnetic resonance spectroscopy in the liver: a review. Liver Int. 28(3), 297-307 (2008). (Pubitemid 351279577)
78. Naressi A, Couturier C, Devos JM et al.: Java-based graphical user interface for the MRUI quantitation package. MAGMA 12(2-3), 141-152 (2001). (Pubitemid 32510133)
79. Szczepaniak LS, Babcock EE, Schick F et al.: Measurement of intracellular triglyceride stores by H spectroscopy: validation in vivo. Am. J. Physiol. 276(5 Pt 1), E977-E989 (1999). (Pubitemid 29249618)
80. Marsman H, Matsushita T, Dierkhising R et al.: Assessment of donor liver steatosis: pathologist or automated software? Hum. Pathol. 35(4), 430-435 (2004). (Pubitemid 38507079)
81. Chen C-H, Lin S-T, Yang C-C, Yeh Y-H, Kuo C-L, Nien C-K: The accuracy of sonography in predicting steatosis and fibrosis in chronic hepatitis C. Digest. Dis. Sci. 53(6), 1699-1706 (2008). (Pubitemid 351624425)
82. Crum-Cianflone N, Dilay A, Collins G et al.: Nonalcoholic fatty liver disease among HIV-infected persons. J. Acquir. Immune Def. Synd. J. AIDS 50(5), 464-473 (2009).
83. Dasarathy S, Dasarathy J, Khiyami A, Joseph R, Lopez R, McCullough AJ: Validity of real time ultrasound in the diagnosis of hepatic steatosis: a prospective study. J. Hepatol. 51(6), 1061-1067 (2009).
84. De Korte PJ, van der Loos TL, van den Tweel JG, Cremers PT, Veldhuijzen van Zanten GO, Lustermans FA: Interpretation of a 'bright' liver in ultrasound examination. Neth. J. Med. 29(1), 5-7 (1986). (Pubitemid 16172730)
85. De Moura AA, Cotrim HP, Barbosa DB et al.: Fatty liver disease in severe obese patients: diagnostic value of abdominal ultrasound. World J. Gastroenterol. 14(9), 1415-1418 (2008). (Pubitemid 351425224)
86. Dietrich CF, Wehrmann T, Zeuzem S, Braden B, Caspary WF, Lembcke B: [Analysis of hepatic echo patterns in chronic hepatitis C]. [German]. Ultraschall in der Medizin (1), 9-14 (1999). (Pubitemid 29157084)
87. Graif M, Yanuka M, Baraz M et al.: Quantitative estimation of attenuation in ultrasound video images: correlation with histology in diffuse liver disease. Invest. Radiol. 35(5), 319-324 (2000). (Pubitemid 30395315)
88. Hepburn MJ, Vos JA, Fillman EP, Lawitz EJ: The accuracy of the report of hepatic steatosis on ultrasonography in patients infected with hepatitis C in a clinical setting: a retrospective observational study. BMC Gastroenterol. 5, 14, (2005).
89. Hultcrantz R , Gabrielsson N: Patients with persistent elevation of aminotransferases: investigation with ultrasonography, radionuclide imaging and liver biopsy. J. Intern. Med. 233(1), 7-12 (1993). (Pubitemid 23064873)
90. Joseph AE, Saverymuttu SH, al-Sam S, Cook MG, Maxwell JD: Comparison of liver histology with ultrasonography in assessing diffuse parenchymal liver disease. Clin. Radiol. 43(1), 26-31 (1991).
91. Kichian K, McLean R, Gramlich LM, Bailey RJ, Bain VG: Nonalcoholic fatty liver disease in patients investigated for elevated liver enzymes. Can. J. Gastroenterol. 17(1), 38-42 (2003). (Pubitemid 36322210)
92. Kim SH, Jeong ML, Jong HK et al.: Appropriateness of a donor liver with respect to macrosteatosis: application of artificial neural networks to US images - initial experience. Radiology 234(3), 793-803 (2005). (Pubitemid 40250823)
93. Kutcher R, Smith GS, Sen F et al.: Comparison of sonograms and liver histologic findings in patients with chronic hepatitis C virus infection. J. Ultrasound Med. 17(5), 321-325 (1998). (Pubitemid 28215555)
94. Lee JY, Kim KM, Lee SG et al.: Prevalence and risk factors of non-alcoholic fatty liver disease in potential living liver donors in Korea: a review of 589 consecutive liver biopsies in a single center. J. Hepatol. 47(2), 239-244 (2007). (Pubitemid 47021248)
95. Mathiesen UL, Franzen LE, Aselius H et al.: Increased liver echogenicity at ultrasound examination reflects degree of steatosis but not of fibrosis in asymptomatic patients with mild/moderate abnormalities of liver transaminases. Digest. Liver Dis. 34(7), 516-522 (2002). (Pubitemid 34830694)
96. Palmentieri B, de Sio I, La Mura V et al.: The role of bright liver echo pattern on ultrasound B-mode examination in the diagnosis of liver steatosis. Digest. Liver Dis. 38(7), 485-489 (2006). (Pubitemid 44356237)
97. Saverymuttu SH, Joseph AE, Maxwell JD: Ultrasound scanning in the detection of hepatic fibrosis and steatosis. Br. Med. J. Clin. Res. Ed. 292(6512), 13-15 (1986). (Pubitemid 16175875)
98. Webb M, Yeshua H, Zelber-Sagi S et al.: Diagnostic value of a computerized hepatorenal index for sonographic quantification of liver steatosis. Am. J. Roentgenol.192(4), 909-914 (2009).
99. Cho CS, Curran S, Schwartz LH et al.: Preoperative radiographic assessment of hepatic steatosis with histologic correlation. J. Am. Coll. Surg. 206(3), 480-488 (2008). (Pubitemid 351282515)
100. Kodama Y, Ng CS, Wu TT et al.: Comparison of CT methods for determining the fat content of the liver. AJR Am. J. Roentgenol. 188(5), 1307-1312 (2007). (Pubitemid 46668513)
101. Lee SW, Park SH, Kim KW et al.: Unenhanced CT for assessment of macrovesicular hepatic steatosis in living liver donors: comparison of visual grading with liver attenuation index. Radiology 244(2), 479-485 (2007).
102. Limanond P, Raman SS, Lassman C et al.: Macrovesicular hepatic steatosis in living related liver donors: correlation between CT and histologic findings. Radiology 230(1), 276-280 (2004). (Pubitemid 37549813)
103. Park SH, Kim PN, Kim KW et al.: Macrovesicular hepatic steatosis in living liver donors: use of CT for quantitative and qualitative assessment. Radiology 239(1), 105-112 (2006).
104. Saadeh S, Younossi ZM, Remer EM et al.: The utility of radiological imaging in nonalcoholic fatty liver disease. Gastroenterology 123(3), 745-750 (2002). (Pubitemid 34977081)
105. Tobari M, Hashimoto E, Yatsuji S, Torii N, Shiratori K: Imaging of nonalcoholic steatohepatitis: advantages and pitfalls of ultrasonography and computed tomography. Intern. Med. 48(10), 739-746 (2009).
106. Yoshimitsu K, Kuroda Y, Nakamuta M et al.: Noninvasive estimation of hepatic steatosis using plain CT vs. chemical-shift MR imaging: significance for living donors. J. Magn. Reson. Imaging 28(3), 678-684 (2008).
107. Mendler MH, Bouillet P, Le SA et al.: Dual-energy CT in the diagnosis and quantification of fatty liver: limited clinical value in comparison to ultrasound scan and single-energy CT, with special reference to iron overload. J. Hepatol. 28(5), 785-794 (1998). (Pubitemid 28223482)