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( Tatsuya Hayashi ),( Satoshi Saitoh ),( Kei Fukuzawa ),( Yoshinori Tsuji ),( Junji Takahashi ),( Yusuke Kawamura ),( Norio Akuta ),( Masahiro Kobayashi ),( Kenji Ikeda ),( Takeshi Fujii ),( Tosiaki M 대한간학회 2017 Gut and Liver Vol.11 No.5
Background/Aims: Noninvasive liver fibrosis evaluation was performed in patients with nonalcoholic fatty liver disease (NAFLD). We used a quantitative method based on the he-patic volume acquired from gadoxetate disodium-enhanced (Gd-EOB-DTPA-enhanced) magnetic resonance imaging (MRI) for diagnosing advanced fibrosis in patients with NAFLD. Methods: A total of 130 patients who were diagnosed with NAFLD and underwent Gd-EOB-DTPA-enhanced MRI were retrospectively included. Histological data were available for 118 patients. Hepatic volumetric parameters, including the left hepatic lobe to right hepatic lobe volume ratio (L/R ratio), were measured. The usefulness of the L/R ratio for diag-nosing fibrosis ≥F3-4 and F4 was assessed using the area under the receiver operating characteristic (AUROC) curve. Multiple regression analysis was performed to identify vari-ables (age, body mass index, serum fibrosis markers, and histological features) that were associated with the L/R ratio. Results: The L/R ratio demonstrated good performance in differentiating advanced fibrosis (AUROC, 0.80; 95% confi-dence interval, 0.72 to 0.88) from cirrhosis (AUROC, 0.87; 95% confidence interval, 0.75 to 0.99). Multiple regression analysis showed that only fibrosis was significantly associat-ed with the L/R ratio (coefficient, 0.121; p<0.0001). Conclu-sions: The L/R ratio, which is not influenced by pathologi-cal parameters other than fibrosis, is useful for diagnosing cirrhosis in patients with NAFLD. (Gut Liver 2017;11:674- 683)