Purpose or Case Report: Non-alcoholic fatty liver disease (NAFLD) is now the most common form of pediatric chronic liver disease. This disease can have profound effects on overall health and is associated with diabetes, heart disease, and an increased risk of hepatocellular carcinoma. The exact pathogenesis of NAFLD remains poorly understood, though it is known to progress to various chronic liver diseases, the most prevalent being hepatic fibrosis. The current gold standard for quantifying fat in the liver is via a core biopsy, which is expensive and carries an inherent risk of morbidity and mortality which makes it unsuitable for screening and monitoring purposes. We propose that MRI can be an effective, fast, and non-invasive method of screening and monitoring pediatric NAFLD. This would allow for earlier diagnosis and monitoring of pediatric NAFLD which would aid in treatment and management of this disease.
Methods & Materials: Children between the ages of 7 and 17 years old with a BMI > 85^th percentile were recruited and consented for a fast MRI. Each of these patients underwent a limited MRI of the abdomen which included a Multi-echo 2-point Dixon imaging protocol covering the liver using a 3T Skyra MR-scanner (Siemens, Germany). The liver proton density fat fraction (PDFF) is calculated based upon the multi-echo method estimation where the fat fraction is based upon multiple pairs of opposed phase and in-phase echoes.
Results: Preliminary data in 10 patients shows that in a high risk pediatric population (BMI > 85^th percentile) signs of NAFLD are present. The fat fraction in these patients ranged from 6.2% to 33.7% with an average of 18.8%. A fat fraction of > 5% is generally considered to be pathologic with higher numbers indicating more severe disease.
Conclusions: In a high risk pediatric population (BMI > 85^th percentile), MRI can be used as a fast and non-invasive way of screening for pediatric NAFLD. This can be used to provide earlier diagnosis and monitoring of pediatric NAFLD helping to treat and manage this disease.