Research progress of magnetic resonance imaging for diagnosis of nonalcoholic steatohepatitis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 HU Fubi , YANG Ru

Department of Radiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, P. R. China;

Corresponding?author：

HU Fubi, Email: yingxianghu_cmc@163.com

Keywords：

nonalcoholic steatohepatitis; MRI; imaging biomarker; noninvasive evaluation; review

DOI：

10.7507/1007-9424.201912083

Video：

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Objective To summarize the research progress of magnetic resonance imaging (MRI) for diagnosis of nonalcoholic steatohepatitis (NASH).Method Relevant literatures at home and abroad were collected to make an review, then summarized the research status and progress of MRI for diagnosis of NASH. Their advantages and disadvantages were summarized.Results A variety of MRI techniques, including MR elastography, gadolinium-ethoxybenzyldiethylenetriaminepentaacetic acid (Gd-EOB-DTPA) enhanced MRI, diffusion-weighted MR imaging, and quantitative MR imaging of fat and iron, had been widely used in diagnosing NASH and shown to have some value. However, there were currently no effective MRI techniques recommended for diagnosing NASH.Conclusions MRI plays an important role in noninvasive assessment of NASH. Future studies are needed to investigate more efficient noninvasive biomarkers and models consisting of imaging and non-imaging biomarkers for diagnosing NASH, to reduce unnecessary biopsies.

Citation： HU Fubi, YANG Ru. Research progress of magnetic resonance imaging for diagnosis of nonalcoholic steatohepatitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(2): 209-215. doi: 10.7507/1007-9424.201912083 Copy

1.	Diehl AM, Day C. Cause, pathogenesis, and treatment of nonalcoholic steatohepatitis. N Engl J Med, 2017, 377(21): 2063-2072.
2.	中華醫學會肝病學分會脂肪肝和酒精性肝病學組, 中國醫師協會脂肪性肝病專家委員會. 非酒精性脂肪性肝病防治指南 (2018 年更新版). 實用肝臟病雜志, 2018, 21(2): 177-186.
3.	Younossi ZM, Golabi P, de Avila L, et al. The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: a systematic review and meta-analysis. J Hepatol, 2019, 71(4): 793-801.
4.	Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology, 2016, 64(1): 73-84.
5.	Fazel Y, Koenig AB, Sayiner M, et al. Epidemiology and natural history of non-alcoholic fatty liver disease. Metabolism, 2016, 65(8): 1017-1025.
6.	Tapper EB, Lok AS. Use of liver imaging and biopsy in clinical practice. N Engl J Med, 2017, 377(8): 756-768.
7.	Ratziu V, Charlotte F, Heurtier A, et al. Sampling variability of liver biopsy in nonalcoholic fatty liver disease. Gastroenterology, 2005, 128(7): 1898-1906.
8.	Eguchi A, Wree A, Feldstein AE. Biomarkers of liver cell death. J Hepatol, 2014, 60(5): 1063-1074.
9.	Drescher HK, Weiskirchen S, Weiskirchen R. Current status in testing for nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). Cells, 2019, 8(8): E845.
10.	Srinivasa Babu A, Wells ML, Teytelboym OM, et al. Elastography in chronic liver disease: modalities, techniques, limitations, and future directions. Radiographics, 2016, 36(7): 1987-2006.
11.	Bayly PV, Garbow JR. Pre-clinical MR elastography: principles, techniques, and applications. J Magn Reson, 2018, 291: 73-83.
12.	Etchell E, Jugé L, Hatt A, et al. Liver stiffness values are lower in pediatric subjects than in adults and increase with age: a multifrequency MR elastography study. Radiology, 2017, 283(1): 222-230.
13.	Petitclerc L, Gilbert G, Nguyen BN, et al. Liver fibrosis quantification by magnetic resonance imaging. Top Magn Reson Imaging, 2017, 26(6): 229-241.
14.	Georges PC, Hui JJ, Gombos Z, et al. Increased stiffness of the rat liver precedes matrix deposition: implications for fibrosis. Am J Physiol Gastrointest Liver Physiol, 2007, 293(6): G1147-G1154.
15.	Salameh N, Larrat B, Abarca-Quinones J, et al. Early detection of steatohepatitis in fatty rat liver by using MR elastography. Radiology, 2009, 253(1): 90-97.
16.	Chen J, Talwalkar JA, Yin M, et al. Early detection of nonalcoholic steatohepatitis in patients with nonalcoholic fatty liver disease by using MR elastography. Radiology, 2011, 259(3): 749-756.
17.	Costa-Silva L, Ferolla SM, Lima AS, et al. MR elastography is effective for the non-invasive evaluation of fibrosis and necroinflammatory activity in patients with nonalcoholic fatty liver disease. Eur J Radiol, 2018, 98: 82-89.
18.	Allen AM, Shah VH, Therneau TM, et al. The role of three-dimensional magnetic resonance elastography in the diagnosis of nonalcoholic steatohepatitis in obese patients undergoing bariatric surgery. Hepatology, 2018, [Epub ahead of print].
19.	Huwart L, Sempoux C, Vicaut E, et al. Magnetic resonance elastography for the noninvasive staging of liver fibrosis. Gastroenterology, 2008, 135(1): 32-40.
20.	Venkatesh SK, Ehman RL. Magnetic resonance elastography of abdomen. Abdom Imaging, 2015, 40(4): 745-759.
21.	Singh S, Venkatesh SK, Wang Z, et al. Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: a systematic review and meta-analysis of individual participant data. Clin Gastroenterol Hepatol, 2015, 13(3): 440-451.
22.	Wagner M, Corcuera-Solano I, Lo G, et al. Technical failure of MR elastography examinations of the liver: experience from a large single-center study. Radiology, 2017, 284(2): 401-412.
23.	Wagner M, Besa C, Bou Ayache J, et al. Magnetic resonance elastography of the liver: qualitative and quantitative comparison of gradient echo and spin echo echoplanar imaging sequences. Invest Radiol, 2016, 51(9): 575-581.
24.	中華醫學會放射學分會腹部學組. 肝膽特異性MRI對比劑釓塞酸二鈉臨床應用專家共識. 中華放射學雜志, 2016, 50(9): 641-646.
25.	Seale MK, Catalano OA, Saini S, et al. Hepatobiliary-specific MR contrast agents: role in imaging the liver and biliary tree. Radiographics, 2009, 29(6): 1725-1748.
26.	Tsuda N, Okada M, Murakami T. Potential of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) for differential diagnosis of nonalcoholic steatohepatitis and fatty liver in rats using magnetic resonance imaging. Invest Radiol, 2007, 42(4): 242-247.
27.	Lickteig AJ, Fisher CD, Augustine LM, et al. Efflux transporter expression and acetaminophen metabolite excretion are altered in rodent models of nonalcoholic fatty liver disease. Drug Metab Dispos, 2007, 35(10): 1970-1978.
28.	Kim T, Murakami T, Hasuike Y, et al. Experimental hepatic dysfunction: evaluation by MRI with Gd-EOB-DTPA. J Magn Reson Imaging, 1997, 7(4): 683-688.
29.	Yamada T, Obata A, Kashiwagi Y, et al. Gd-EOB-DTPA-enhanced-MR imaging in the inflammation stage of nonalcoholic steatohepatitis (NASH) in mice. Magn Reson Imaging, 2016, 34(6): 724-729.
30.	Sonoda A, Nitta N, Ohta S, et al. The possibility of differentiation between nonalcoholic steatohepatitis and fatty liver in rabbits on Gd-EOB-DTPA-enhanced open-type MRI scans. Acad Radiol, 2011, 18(4): 525-529.
31.	丁鶯, 曾蒙蘇, 饒圣祥, 等. 肝細胞特異性對比劑釓塞酸二鈉增強磁共振檢查對非酒精性脂肪肝診斷及分級的潛在價值. 中華肝臟病雜志, 2015, 23(4): 297-299.
32.	Wu Z, Matsui O, Kitao A, et al. Usefulness of Gd-EOB-DTPA-enhanced MR imaging in the evaluation of simple steatosis and nonalcoholic steatohepatitis. J Magn Reson Imaging, 2013, 37(5): 1137-1143.
33.	Bastati N, Feier D, Wibmer A, et al. Noninvasive differentiation of simple steatosis and steatohepatitis by using gadoxetic acid-enhanced MR imaging in patients with nonalcoholic fatty liver disease: a proof-of-concept study. Radiology, 2014, 271(3): 739-747.
34.	Bashir MR, Merkle EM. Improved liver lesion conspicuity by increasing the flip angle during hepatocyte phase MR imaging. Eur Radiol, 2011, 21(2): 291-294.
35.	Rosenkrantz AB, Padhani AR, Chenevert TL, et al. Body diffusion kurtosis imaging: basic principles, applications, and considerations for clinical practice. J Magn Reson Imaging, 2015, 42(5): 1190-1202.
36.	Joo I, Lee JM, Yoon JH, et al. Nonalcoholic fatty liver disease: intravoxel incoherent motion diffusion-weighted MR imaging-an experimental study in a rabbit model. Radiology, 2014, 270(1): 131-140.
37.	Xie Y, Zhang H, Jin C, et al. Gd-EOB-DTPA-enhanced T1ρ imaging vs diffusion metrics for assessment liver inflammation and early stage fibrosis of nonalcoholic steatohepatitis in rabbits. Magn Reson Imaging, 2018, 48: 34-41.
38.	鄧宇, 梁長虹, 伍筱梅, 等. 體素內不相干運動磁共振擴散加權成像診斷兔非酒精性脂肪肝病. 中國醫學影像技術, 2016, 32(7): 1000-1004.
39.	Li C, Ye J, Peng Y, et al. Evaluation of diffusion kurtosis imaging in stratification of nonalcoholic fatty liver disease and early diagnosis of nonalcoholic steatohepatitis in a rabbit model. Magn Reson Imaging, 2019, 63: 267-273.
40.	李暢, 王譯妮, 王猛, 等. 拉伸指數模型多b值擴散成像對非酒精性脂肪肝定量診斷的價值. 中華醫學雜志, 2019, 99(7): 500-504.
41.	Porter DA, Heidemann RM. High resolution diffusion-weighted imaging using readout-segmented echo-planar imaging, parallel imaging and a two-dimensional navigator-based reacquisition. Magn Reson Med, 2009, 62(2): 468-475.
42.	Setsompop K, Cohen-Adad J, Gagoski BA, et al. Improving diffusion MRI using simultaneous multi-slice echo planar imaging. Neuroimage, 2012, 63(1): 569-580.
43.	Qu Y, Li M, Hamilton G, et al. Diagnostic accuracy of hepatic proton density fat fraction measured by magnetic resonance imaging for the evaluation of liver steatosis with histology as reference standard: a meta-analysis. Eur Radiol, 2019, 29(10): 5180-5189.
44.	Yokoo T, Serai SD, Pirasteh A, et al. Linearity, bias, and precision of hepatic proton density fat fraction measurements by using mr imaging: a meta-analysis. Radiology, 2018, 286(2): 486-498.
45.	Caussy C, Reeder SB, Sirlin CB, et al. Noninvasive, quantitative assessment of liver fat by MRI-PDFF as an endpoint in NASH trials. Hepatology, 2018, 68(2): 763-772.
46.	Patel J, Bettencourt R, Cui J, et al. Association of noninvasive quantitative decline in liver fat content on MRI with histologic response in nonalcoholic steatohepatitis. Therap Adv Gastroenterol, 2016, 9(5): 692-701.
47.	Angulo P, Kleiner DE, Dam-Larsen S, et al. Liver fibrosis, but no other histologic features, is associated with long-term outcomes of patients with nonalcoholic fatty liver disease. Gastroenterology, 2015, 149(2): 389-397.
48.	Kim TH, Jun HY, Kim KJ, et al. Hepatic alanine differentiates nonalcoholic steatohepatitis from simple steatosis in humans and mice: a proton mr spectroscopy study with long echo time. J Magn Reson Imaging, 2017, 46(5): 1298-1310.
49.	Abrigo JM, Shen J, Wong VW, et al. Non-alcoholic fatty liver disease: spectral patterns observed from an in vivo phosphorus magnetic resonance spectroscopy study. J Hepatol, 2014, 60(4): 809-815.
50.	George DK, Goldwurm S, MacDonald GA, et al. Increased hepatic iron concentration in nonalcoholic steatohepatitis is associated with increased fibrosis. Gastroenterology, 1998, 114(2): 311-318.
51.	陳曉麗, 宋彬, 李真林, 等. 影像學評估肝臟鐵含量的研究進展. 中國普外基礎與臨床雜志, 2019, 26(2): 224-228.
52.	Kim TH, Jeong CW, Jun HY, et al. Noninvasive differential diagnosis of liver iron contents in nonalcoholic steatohepatitis and simple steatosis using multiecho dixon magnetic resonance imaging. Acad Radiol, 2019, 26(6): 766-774.
53.	梁長虹, 田捷, 孫應實, 等. 積極開展影像組學研究, 推進影像組學的發展和臨床轉化. 中華放射學雜志, 2017, 51(12): 897-898.

1. Diehl AM, Day C. Cause, pathogenesis, and treatment of nonalcoholic steatohepatitis. N Engl J Med, 2017, 377(21): 2063-2072.
2. 中華醫學會肝病學分會脂肪肝和酒精性肝病學組, 中國醫師協會脂肪性肝病專家委員會. 非酒精性脂肪性肝病防治指南 (2018 年更新版). 實用肝臟病雜志, 2018, 21(2): 177-186.
3. Younossi ZM, Golabi P, de Avila L, et al. The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: a systematic review and meta-analysis. J Hepatol, 2019, 71(4): 793-801.
4. Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology, 2016, 64(1): 73-84.
5. Fazel Y, Koenig AB, Sayiner M, et al. Epidemiology and natural history of non-alcoholic fatty liver disease. Metabolism, 2016, 65(8): 1017-1025.
6. Tapper EB, Lok AS. Use of liver imaging and biopsy in clinical practice. N Engl J Med, 2017, 377(8): 756-768.
7. Ratziu V, Charlotte F, Heurtier A, et al. Sampling variability of liver biopsy in nonalcoholic fatty liver disease. Gastroenterology, 2005, 128(7): 1898-1906.
8. Eguchi A, Wree A, Feldstein AE. Biomarkers of liver cell death. J Hepatol, 2014, 60(5): 1063-1074.
9. Drescher HK, Weiskirchen S, Weiskirchen R. Current status in testing for nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). Cells, 2019, 8(8): E845.
10. Srinivasa Babu A, Wells ML, Teytelboym OM, et al. Elastography in chronic liver disease: modalities, techniques, limitations, and future directions. Radiographics, 2016, 36(7): 1987-2006.
11. Bayly PV, Garbow JR. Pre-clinical MR elastography: principles, techniques, and applications. J Magn Reson, 2018, 291: 73-83.
12. Etchell E, Jugé L, Hatt A, et al. Liver stiffness values are lower in pediatric subjects than in adults and increase with age: a multifrequency MR elastography study. Radiology, 2017, 283(1): 222-230.
13. Petitclerc L, Gilbert G, Nguyen BN, et al. Liver fibrosis quantification by magnetic resonance imaging. Top Magn Reson Imaging, 2017, 26(6): 229-241.
14. Georges PC, Hui JJ, Gombos Z, et al. Increased stiffness of the rat liver precedes matrix deposition: implications for fibrosis. Am J Physiol Gastrointest Liver Physiol, 2007, 293(6): G1147-G1154.
15. Salameh N, Larrat B, Abarca-Quinones J, et al. Early detection of steatohepatitis in fatty rat liver by using MR elastography. Radiology, 2009, 253(1): 90-97.
16. Chen J, Talwalkar JA, Yin M, et al. Early detection of nonalcoholic steatohepatitis in patients with nonalcoholic fatty liver disease by using MR elastography. Radiology, 2011, 259(3): 749-756.
17. Costa-Silva L, Ferolla SM, Lima AS, et al. MR elastography is effective for the non-invasive evaluation of fibrosis and necroinflammatory activity in patients with nonalcoholic fatty liver disease. Eur J Radiol, 2018, 98: 82-89.
18. Allen AM, Shah VH, Therneau TM, et al. The role of three-dimensional magnetic resonance elastography in the diagnosis of nonalcoholic steatohepatitis in obese patients undergoing bariatric surgery. Hepatology, 2018, [Epub ahead of print].
19. Huwart L, Sempoux C, Vicaut E, et al. Magnetic resonance elastography for the noninvasive staging of liver fibrosis. Gastroenterology, 2008, 135(1): 32-40.
20. Venkatesh SK, Ehman RL. Magnetic resonance elastography of abdomen. Abdom Imaging, 2015, 40(4): 745-759.
21. Singh S, Venkatesh SK, Wang Z, et al. Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: a systematic review and meta-analysis of individual participant data. Clin Gastroenterol Hepatol, 2015, 13(3): 440-451.
22. Wagner M, Corcuera-Solano I, Lo G, et al. Technical failure of MR elastography examinations of the liver: experience from a large single-center study. Radiology, 2017, 284(2): 401-412.
23. Wagner M, Besa C, Bou Ayache J, et al. Magnetic resonance elastography of the liver: qualitative and quantitative comparison of gradient echo and spin echo echoplanar imaging sequences. Invest Radiol, 2016, 51(9): 575-581.
24. 中華醫學會放射學分會腹部學組. 肝膽特異性MRI對比劑釓塞酸二鈉臨床應用專家共識. 中華放射學雜志, 2016, 50(9): 641-646.
25. Seale MK, Catalano OA, Saini S, et al. Hepatobiliary-specific MR contrast agents: role in imaging the liver and biliary tree. Radiographics, 2009, 29(6): 1725-1748.
26. Tsuda N, Okada M, Murakami T. Potential of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) for differential diagnosis of nonalcoholic steatohepatitis and fatty liver in rats using magnetic resonance imaging. Invest Radiol, 2007, 42(4): 242-247.
27. Lickteig AJ, Fisher CD, Augustine LM, et al. Efflux transporter expression and acetaminophen metabolite excretion are altered in rodent models of nonalcoholic fatty liver disease. Drug Metab Dispos, 2007, 35(10): 1970-1978.
28. Kim T, Murakami T, Hasuike Y, et al. Experimental hepatic dysfunction: evaluation by MRI with Gd-EOB-DTPA. J Magn Reson Imaging, 1997, 7(4): 683-688.
29. Yamada T, Obata A, Kashiwagi Y, et al. Gd-EOB-DTPA-enhanced-MR imaging in the inflammation stage of nonalcoholic steatohepatitis (NASH) in mice. Magn Reson Imaging, 2016, 34(6): 724-729.
30. Sonoda A, Nitta N, Ohta S, et al. The possibility of differentiation between nonalcoholic steatohepatitis and fatty liver in rabbits on Gd-EOB-DTPA-enhanced open-type MRI scans. Acad Radiol, 2011, 18(4): 525-529.
31. 丁鶯, 曾蒙蘇, 饒圣祥, 等. 肝細胞特異性對比劑釓塞酸二鈉增強磁共振檢查對非酒精性脂肪肝診斷及分級的潛在價值. 中華肝臟病雜志, 2015, 23(4): 297-299.
32. Wu Z, Matsui O, Kitao A, et al. Usefulness of Gd-EOB-DTPA-enhanced MR imaging in the evaluation of simple steatosis and nonalcoholic steatohepatitis. J Magn Reson Imaging, 2013, 37(5): 1137-1143.
33. Bastati N, Feier D, Wibmer A, et al. Noninvasive differentiation of simple steatosis and steatohepatitis by using gadoxetic acid-enhanced MR imaging in patients with nonalcoholic fatty liver disease: a proof-of-concept study. Radiology, 2014, 271(3): 739-747.
34. Bashir MR, Merkle EM. Improved liver lesion conspicuity by increasing the flip angle during hepatocyte phase MR imaging. Eur Radiol, 2011, 21(2): 291-294.
35. Rosenkrantz AB, Padhani AR, Chenevert TL, et al. Body diffusion kurtosis imaging: basic principles, applications, and considerations for clinical practice. J Magn Reson Imaging, 2015, 42(5): 1190-1202.
36. Joo I, Lee JM, Yoon JH, et al. Nonalcoholic fatty liver disease: intravoxel incoherent motion diffusion-weighted MR imaging-an experimental study in a rabbit model. Radiology, 2014, 270(1): 131-140.
37. Xie Y, Zhang H, Jin C, et al. Gd-EOB-DTPA-enhanced T1ρ imaging vs diffusion metrics for assessment liver inflammation and early stage fibrosis of nonalcoholic steatohepatitis in rabbits. Magn Reson Imaging, 2018, 48: 34-41.
38. 鄧宇, 梁長虹, 伍筱梅, 等. 體素內不相干運動磁共振擴散加權成像診斷兔非酒精性脂肪肝病. 中國醫學影像技術, 2016, 32(7): 1000-1004.
39. Li C, Ye J, Peng Y, et al. Evaluation of diffusion kurtosis imaging in stratification of nonalcoholic fatty liver disease and early diagnosis of nonalcoholic steatohepatitis in a rabbit model. Magn Reson Imaging, 2019, 63: 267-273.
40. 李暢, 王譯妮, 王猛, 等. 拉伸指數模型多b值擴散成像對非酒精性脂肪肝定量診斷的價值. 中華醫學雜志, 2019, 99(7): 500-504.
41. Porter DA, Heidemann RM. High resolution diffusion-weighted imaging using readout-segmented echo-planar imaging, parallel imaging and a two-dimensional navigator-based reacquisition. Magn Reson Med, 2009, 62(2): 468-475.
42. Setsompop K, Cohen-Adad J, Gagoski BA, et al. Improving diffusion MRI using simultaneous multi-slice echo planar imaging. Neuroimage, 2012, 63(1): 569-580.
43. Qu Y, Li M, Hamilton G, et al. Diagnostic accuracy of hepatic proton density fat fraction measured by magnetic resonance imaging for the evaluation of liver steatosis with histology as reference standard: a meta-analysis. Eur Radiol, 2019, 29(10): 5180-5189.
44. Yokoo T, Serai SD, Pirasteh A, et al. Linearity, bias, and precision of hepatic proton density fat fraction measurements by using mr imaging: a meta-analysis. Radiology, 2018, 286(2): 486-498.
45. Caussy C, Reeder SB, Sirlin CB, et al. Noninvasive, quantitative assessment of liver fat by MRI-PDFF as an endpoint in NASH trials. Hepatology, 2018, 68(2): 763-772.
46. Patel J, Bettencourt R, Cui J, et al. Association of noninvasive quantitative decline in liver fat content on MRI with histologic response in nonalcoholic steatohepatitis. Therap Adv Gastroenterol, 2016, 9(5): 692-701.
47. Angulo P, Kleiner DE, Dam-Larsen S, et al. Liver fibrosis, but no other histologic features, is associated with long-term outcomes of patients with nonalcoholic fatty liver disease. Gastroenterology, 2015, 149(2): 389-397.
48. Kim TH, Jun HY, Kim KJ, et al. Hepatic alanine differentiates nonalcoholic steatohepatitis from simple steatosis in humans and mice: a proton mr spectroscopy study with long echo time. J Magn Reson Imaging, 2017, 46(5): 1298-1310.
49. Abrigo JM, Shen J, Wong VW, et al. Non-alcoholic fatty liver disease: spectral patterns observed from an in vivo phosphorus magnetic resonance spectroscopy study. J Hepatol, 2014, 60(4): 809-815.
50. George DK, Goldwurm S, MacDonald GA, et al. Increased hepatic iron concentration in nonalcoholic steatohepatitis is associated with increased fibrosis. Gastroenterology, 1998, 114(2): 311-318.
51. 陳曉麗, 宋彬, 李真林, 等. 影像學評估肝臟鐵含量的研究進展. 中國普外基礎與臨床雜志, 2019, 26(2): 224-228.
52. Kim TH, Jeong CW, Jun HY, et al. Noninvasive differential diagnosis of liver iron contents in nonalcoholic steatohepatitis and simple steatosis using multiecho dixon magnetic resonance imaging. Acad Radiol, 2019, 26(6): 766-774.
53. 梁長虹, 田捷, 孫應實, 等. 積極開展影像組學研究, 推進影像組學的發展和臨床轉化. 中華放射學雜志, 2017, 51(12): 897-898.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Research progress of magnetic resonance imaging for diagnosis of nonalcoholic steatohepatitis

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