The Clinical Value and Appropriateness Criteria of Upper Abdominal Magnetic Resonance Examinations in Patients Before and After Bariatric Surgery: a Study of 837 Images



The abdominal magnetic resonance (MR) examinations have been increasingly applied in patients with obesity. However, few studies analyzed the appropriateness of this examination. This study is aimed to evaluate the feasibility and clinical value of upper abdominal MR in quantification of visceral/subcutaneous adipose tissue (VAT/SAT) and liver fat fraction (LFF) in patients before and after bariatric surgery.


All patients who underwent bariatric surgery from November 2017 to November 2019 in the prospectively maintained, IRB-approved database of our institution were queried. The images of all MR studies were retrospectively reviewed and analyzed.


In total, 570 patients with 837 upper abdominal MR examinations were analyzed. The VAT/SAT can be clearly visualized and quantified on fat liver acquisition with volume acceleration-flexible (LAVA-Flex) sequence. The present rate of a single axial slice at the level of the L1–L2 intervertebral disc was 93.1% (779/837). The LFF could be quantitatively evaluated on all of the proton density fat fraction (PDFF) maps (100%, 837/837). Occasional findings may include cholelithiasis, cysts, hepatic hemangioma, and renal angiomyolipoma, which can be clearly diagnosed by MR.


The upper abdominal MR is featured by well feasibility and clear clinical value when applying in patients with obesity. We can use the results to do clinical research and evaluate obesity-related disease risks before and after surgery, thus providing suggestions to choose the type of surgery for patients with different risk levels in the future. MR scanning including fat LAVA-Flex images with the inclusion of L1–L2 level and PDFF measurements is suggested for the VAT/SAT/LFF quantification.

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The authors would like to thank all of the involved study investigators, staffs, clinicians, nurses, and technicians for dedicating their time and skills to the completion of this study.


This study was supported by Grant No. 61801311 from the National Natural Science Foundation of China (Han Lv), No. [2015] 160 from Beijing Scholars Program (Zhenchang Wang), Grant No. 7182044 from Beijing Natural Science Foundation (Han Lv), No. PX2018001 from Beijing Hospitals Authority (Han Lv), QML20180103 from Beijing Hospitals Authority Youth Programme (Han Lv), No. YYZZ2017B01 from Beijing Friendship Hospital, Capital Medical University (Han Lv), and No. 2019M660717 from China Postdoctoral Science Foundation (Han Lv).

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Correspondence to Zhongtao Zhang or Zhenchang Wang.

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Informed consent was obtained from all individual participants included in this study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Committees of Beijing Friendship Hospital, Capital Medical University.

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Lv, H., Li, M., Liu, Y. et al. The Clinical Value and Appropriateness Criteria of Upper Abdominal Magnetic Resonance Examinations in Patients Before and After Bariatric Surgery: a Study of 837 Images. OBES SURG 30, 3784–3791 (2020).

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  • MR
  • Obesity
  • Bariatric surgery
  • Adipose tissue
  • Liver fat fraction