Abstract:

Background: Hepatic steatosis has been shown to worsen the course of liver disease in chronic hepatitis C (CHC) patients, it may reduce the efficacy of antiviral therapy and accelerate disease progression. In this cross-sectional study, we aimed to evaluate the role of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the quantitative assessment and grading of hepatic steatosis to evaluate the association between hepatic steatosis and fibrosis in Egyptian genotype 4-CHC (G4-CHC) patients.

Results: Histopathological hepatic steatosis was found in 70.3% of patients. No correlation was found between the CT ratio and pathological hepatic steatosis. Proton-density fat fraction, T1-fat fraction and fat percentage correlated with histological steatosis grading (r=0.953, p< 0.001; r=0.380,p=0.027 and r=0.384, p=0.025 respectively).An agreement between steatosis grading by histology and 1H-MRS was found in 74.2% of patients. Compared to other MRI modalities, proton-density fat fraction had the highest area under the receiver operating characteristic curve (AUC), with 0.910,0.931, and 0.975 for mild, moderate, and severe steatosis respectively. The cut-off with the best ability to predict steatosis was>4.95 for a proton-density fat fraction (AUC=0.958) with 95.8% sensitivity, 90% specificity, 78.5% positive predictive value and 96.1% negative predictive value.

Conclusion:1H-MRS had good diagnostic performance in predicting hepatic steatosis in G4-CHC patients and hence it may offer a useful-noninvasive quantitative modality for grading of steatosis with clinical applicability especially in those where a liver biopsy cannot be done.