Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2022; 10(25): 8906-8921
Published online Sep 6, 2022. doi: 10.12998/wjcc.v10.i25.8906
How to select the quantitative magnetic resonance technique for subjects with fatty liver: A systematic review
You-Wei Li, Yang Jiao, Na Chen, Qiang Gao, Yu-Kun Chen, Yuan-Fang Zhang, Qi-Ping Wen, Zong-Ming Zhang
You-Wei Li, Yu-Kun Chen, Yuan-Fang Zhang, Qi-Ping Wen, Department of Radiology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing 100144, China
Yang Jiao, Department of Rehabilitation Psychology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing 100144, China
Na Chen, Department of Otorhinolaryngology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing 100144, China
Qiang Gao, Department of Gastroenterology and Hepatology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing 100144, China
Zong-Ming Zhang, Department of General Surgery, Beijing Electric Power Hospital, State Grid Corporation of China, Capital Medical University, Beijing 100073, China
Author contributions: Li YW and Jiao Y contributed equally to this study; Zhang ZM conceived and designed this study; Li YW, Jiao Y, Chen N, Gao Q and Chen YK drafted the manuscript; Zhang YF developed the search strategy; Wen QP provided statistical expertise; All authors contributed to developing the selection criteria, risk-of-bias assessment strategy, and data extraction criteria, they read, provided feedback, and approved the final manuscript.
Supported by Beijing Municipal Science and Technology Commission, No. Z171100000417056; and Key Support Project of Guo Zhong Health Care of China General Technology Group, No. SGGK202201001.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zong-Ming Zhang, MD, PhD, Chief Doctor, Director, Professor, Department of General Surgery, Beijing Electric Power Hospital, State Grid Corporation of China, Capital Medical University, No. 1 Taipingqiaoxili, Fengtai District, Beijing 100073, China. zhangzongming@mail.tsinghua.edu.cn
Received: January 25, 2022
Peer-review started: January 25, 2022
First decision: May 9, 2022
Revised: May 25, 2022
Accepted: July 22, 2022
Article in press: July 22, 2022
Published online: September 6, 2022
Processing time: 213 Days and 0.2 Hours
ARTICLE HIGHLIGHTS
Research background

Fatty liver can cause hepatocyte injury, inflammation, fibrosis, and eventually cirrhosis, with a high risk for liver failure and hepatocellular carcinoma. Early quantitative assessment of liver fat content is essential for patients with fatty liver disease.

Research motivation

Mounting evidence has shown that magnetic resonance (MR) technique has high accuracy in the quantitative analysis of fatty liver disease. However, many packaging methods and postprocessing functions have puzzled radiologists in clinical applications. Hence, selecting quantitative MR imaging (MRI) for patients with fatty liver disease is challenging.

Research objectives

To provide information for the proper selection of commonly used quantitative MR techniques to quantify fatty liver.

Research methods

A systematic review of the literature from 1983 to May 2021 using PubMed, Embase, and Cochrane Library was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Research results

A total of 114 articles were included, including 35 articles on MR techniques for measurement of hepatic fat content, 39 articles on reviews and meta-analysis, and 40 studies for further qualitative analysis. Because the overall moderate and high risk of bias in the 40 studies was approximately 50.0%, qualitative synthesis other than quantitative synthesis was used in this systematic review. The principle, main technical factors, advantages, and disadvantages of 1H-MR spectroscopy, two-point Dixon imaging, and multiple-point Dixon imaging, as well as their clinical diagnostic performance were summarized and analyzed.

Research conclusions

Proton density fat fraction (PDFF) derived from multiple-point Dixon imaging is a noninvasive method that provides an accurate, quantitative measurement of hepatic fat content.

Research perspectives

The accuracy of the PDFF derived from multiple-point Dixon imaging can be affected by fibrosis and severe steatosis. Therefore, the multiparametric MRI protocol might be helpful in liver tissue characterization and thereby in the risk stratification and therapeutic management of patients with non-alcoholic fatty liver disease.