Role of Magnetic Resonance Imaging in the Monitoring of Patients with Nonalcoholic Fatty Liver Disease: Comparison with Ultrasonography, Lipid Profile, and Body Mass Index

Aim: The aim of this study was to study the role of magnetic resonance imaging (MRI) in monitoring hepatic fat content in cases of nonalcoholic fatty liver disease (NAFLD). Materials and methods: 41 adults (mean age: 39 years, 22males; 19 females) with NAFLD were included after obtaining approval fromthe institutional ethics committee. The baseline clinical (weight, bodymass index [BMI]) and biochemical parameters, fatty liver grade on ultrasonography (USG), and hepatic fat signal fraction (FSF) using dual-echo chemical shift imaging and proton density fat fraction on magnetic resonance spectroscopy (MRS-PDFF) were assessed, before and after intervention (dietary and lifestyle changes and oral vitamin E for six months). They were categorized into Group A (good compliance to intervention) and Group B (poor compliance), and the clinical and imaging parameters were compared between them. Results: After intervention, Group A (n = 30) showed significant reduction in BMI (28.35 +/- 3.25 to 27.14 +/- 3.24 kg/m(2); P < 0.001), hepatic FSF (19.30 +/- 9.09% to 11.18 +/- 7.61%; P < 0.05), and MRS-PDFF (18.79 +/- 8.53% to 10.64 +/- 6.66%). In Group B (n = 11), there was significant increase in BMI (28.85 +/- 2.41 to 29.31 +/- 2.57 kg/m(2); P < 0.001), hepatic FSF (18.96 +/- 9.79% to 21.48 +/- 11.80%; P < 0.05), and reduction in high-density lipoproteins (P < 0.05). Although there was good correlation between USG and MRS in quantifying liver fat (r = 0.84-0.87; P < 0.001), USG was unable to detect <5.3% change in hepatic fat. There was poor correlation between lipid profile and MRS-PDFF. Change in body weight significantly correlated with change in hepatic fat content (r = 0.76; P < 0.001). Conclusion: MRI is useful in accurately quantifying and in monitoring hepatic fat content and is better than clinical and biochemical parameters and USG.