Macroscopic heterogeneity of liver fat: an MR-based study in type-2 diabetic patients

Objective

To assess the heterogeneity of liver fat deposition with MR of the liver in type-2 diabetic (T2D) patients.

Methods

We enrolled 121 consecutive T2D patients. The reference standard was 3.0-T ¹H-MR spectroscopy. Hepatic steatosis was defined as liver fat content (LFC) ≥5.56?%. A triple-echo gradient-echo sequence corrected for T1 recovery and T2* decay was used to calculate LFC in left and right livers and hepatic segments. Analyses were performed using a linear mixed model.

Results

Fifty-nine (48.8?%) patients had liver steatosis, whereas 62 (51.2?%) did not. Steatosis was greater in the right than in the left liver (P?P?P?P?P?=?0.0002 respectively) patients [mean maximum difference: 3.98?% (range: 0.74–19.32?%)]. In 23 patients (19?%), LFC was <5.56?% in one segment, whereas it was ≥5.56?% in at least one other.

Conclusion

Overall, the mean segmental/lobar variability of steatosis is low. However, segmental variability can sometimes lead to a misdiagnosis.

Key Points

• There is a need for methods quantifying steatosis over a large region.
• Steatosis is usually greater in the right than left lobe of the liver.
• Steatosis within both left and right hepatic lobes is segmentally heterogeneous.
• Segmental variability of steatosis can result in misdiagnosis.