A Comparative Study on Role of MR Chemical Shift Imaging (mDIXON) and Ultrasound Elastography with CT Hounsfield Unit in Assessment of Early Stages of Non-Alcoholic Fatty Liver Disease

Introduction: Non-alcoholic steatohepatitis (NASH), which is more severe than moderate fatty liver disease (NAFL) and is associated with an increased risk of liver cirrhosis and consequences, is a common disorder characterised by the build-up of triglycerides in liver cells. NAFLD frequently presents symptom-free until complications emerge, makes early detection difficult. The most invasive and limited diagnostic method is liver biopsy. Promising solutions for NAFLD screening and early diagnosis are non-invasive imaging methods. This study assessed the precision of CT Hounsfield units, ultrasound elastography, and MR chemical shift imaging (mDIXON) in determining early NAFLD stages. Methods: At a tertiary care facility in India, we did a prospective cross-sectional study with 80 patients who had NAFLD that had been discovered by incidentally. To measure hepatic steatosis and fibrosis, the study compared m-DIXON, ultrasound grayscale imaging, CT Hounsfield unit, and ultrasound point shear wave elastography (US- pSWE). Descriptive statistics, chi-square tests, ANOVA, and regression analysis were used in the data analysis. Results: Our findings revealed that the majority (56.25%) of participants had grade I fatty liver, with hepatomegaly observed in 72.5% of participants. Strong correlations were identified between CT attenuation values and ultrasound greyscale imaging for fatty liver grading and between CT values and MRI chemical shift imaging for fat percentage determination. However, the CT's relation with US- pSWE for hepatic fibrosis evaluation was inconsistent. Remarkably, MRI's proton-density fat fraction emerged as a precise non-invasive biomarker for steatosis measurement. Conclusion: In conclusion, non-invasive imaging modalities like mDIXON, CT Hounsfield units, and MRI chemical shift imaging contribute to NAFLD screening and early diagnosis. They offer precise assessments of hepatic steatosis and fibrosis, facilitating timely management and enhanced patient care.