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Master Thesis

Quantification de la stéatose hépatique chez les patients NAFLD : évaluation de l'index hépato-rénal échographique en comparaison à l'IRM

Abstract : Purpose: Non-alcoholic fatty liver disease or NAFLD is nowadays the leading cause of chronic liver disease and affects approximately 25% of the population, particularly obese and diabetic patients. Currently, the reference method for diagnosing formally this disease is histological analysis by liver puncture-biopsy. MRI allows the diagnosis and the quantification of this steatosis, whereas to date ultrasound only allows us to confirm or deny the presence of the steatosis, without quantifying it. Objective: Our objective is to assess the diagnostic value of the ultrasound hepatorenal index (HRI) for the quantification of hepatic steatosis by comparison with the MRI measurement as a diagnostic reference. Materials and Methods: We prospectively included 53 patients consulting in the hepato-gastroenterology department for the follow-up of their NAFLD at the Clermont -Ferrand University Hospital between June 2020 and April 2021. After the clinical consultation by an expert doctor during which an ultrasound with measurement of hepato-renal index was performed, the patients were convened for the realization of a hepatic MRI (3T) with a technique of quantification of steatosis by DIXON 6 echoes sequence and a post-processing analysis by the MR-Quantif software. Ultrasound and MRI data were then compared to assess the strength of the association between these two techniques. For that, we used the linear regression model, then we looked for a potential non-linearity of the relationship by fitting more complex model including threshold models. Results: Our study showed a statistically significant positive correlation between the HRI and the quantification of fat in MRI 6 echoes (r=0,602, p < 0,0001). The analysis of non-linearity led to retain a threshold model as the best descriptor of this relationship. The HRI increases sharply with the percentage of fat in MRI 6 echoes up to a threshold of 16%. Beyond this threshold, the HRI no longer increases with the percentage of fat in MRI. It is important to note, however, that our sample did not include any patient with hepatic steatosis greater than 39% on MRI. We did not detect any influence of gender, BMI or waist circumference on this relationship. Conclusion: All the findings from this study show that the use of HRI in the detection and quantification of hepatic steatosis is effective in patients with mild or moderate steatosis (threshold of 16% fat in MRI 6 echos) but cannot be recommended for the more severe grades of steatosis within the range of values observed in our study.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03616050
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Submitted on : Tuesday, March 22, 2022 - 10:32:41 AM
Last modification on : Thursday, March 24, 2022 - 3:40:39 AM

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Constance Gaillard. Quantification de la stéatose hépatique chez les patients NAFLD : évaluation de l'index hépato-rénal échographique en comparaison à l'IRM. Médecine humaine et pathologie. 2021. ⟨dumas-03616050⟩

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