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Forschungsdatenbank PMU-SQQUID

Fat-free muscle mass in magnetic resonance imaging predicts acute-on-chronic liver failure and survival in decompensated cirrhosis.
Praktiknjo, M; Book, M; Luetkens, J; Pohlmann, A; Meyer, C; Thomas, D; Jansen, C; Feist, A; Chang, J; Grimm, J; Lehmann, J; Strassburg, CP; Abraldes, JG; Kukuk, G; Trebicka, J;
Hepatology. 2018; 67(3):1014-1026
Originalarbeiten (Zeitschrift)


Grimm Jochen


Muscle mass seems to be a prognostic marker in patients with liver cirrhosis. However, reported methods to quantify muscle mass are heterogeneous, consented cutoff values are missing, and most studies have used computed tomography. This study evaluated fat-free muscle area (FFMA) as a marker of sarcopenia using magnetic resonance imaging (MRI) in patients with decompensated cirrhosis with transjugular intrahepatic portosystemic shunt (TIPS). The total erector spinae muscle area and the intramuscular fat tissue area were measured and subtracted to calculate the FFMA in 116 patients with cirrhosis by TIPS and MRI. The training cohort of 71 patients compared computed tomography-measured transversal psoas muscle thickness with FFMA. In 15 patients MRI was performed before and after TIPS, and in 12 patients follistatin serum measurements were carried out. The results on FFMA were confirmed in a validation cohort of 45 patients. FFMA correlated with follistatin and transversal psoas muscle thickness and showed slightly better association with survival than transversal psoas muscle thickness. Gender-specific cutoff values for FFMA were determined for sarcopenia. Decompensation (ascites, overt hepatic encephalopathy) persisted after TIPS in the sarcopenia group but resolved in the nonsarcopenia group. Sarcopenic patients showed no clinical improvement after TIPS as well as higher mortality, mainly due to development of acute-on-chronic liver failure. FFMA was an independent predictor of survival in these patients.

Useful keywords (using NLM MeSH Indexing)

Acute-On-Chronic Liver Failure/complications*

Acute-On-Chronic Liver Failure/mortality

Acute-On-Chronic Liver Failure/surgery





Body Composition




Liver Cirrhosis/complications*

Liver Cirrhosis/mortality

Liver Cirrhosis/surgery

Magnetic Resonance Imaging/methods*


Middle Aged

Muscle, Skeletal/diagnostic imaging*

Portasystemic Shunt, Transjugular Intrahepatic/adverse effects

Portasystemic Shunt, Transjugular Intrahepatic/methods

ROC Curve

Reproducibility of Results

Retrospective Studies

Sarcopenia/diagnostic imaging*


Survival Rate

Tomography, X-Ray Computed

Young Adult