{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:52:22Z","timestamp":1791939142452,"version":"4.3.4"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100013076","name":"National Major Science and Technology Projects of China","doi-asserted-by":"publisher","award":["2025ZD0551000"],"award-info":[{"award-number":["2025ZD0551000"]}],"id":[{"id":"10.13039\/501100013076","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013076","name":"National Major Science and Technology Projects of China","doi-asserted-by":"publisher","award":["2025ZD0551004"],"award-info":[{"award-number":["2025ZD0551004"]}],"id":[{"id":"10.13039\/501100013076","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Conventional diffusion MRI inadequately characterizes heterogeneous microstructural changes in metabolic dysfunction\u2010associated steatotic liver disease (MASLD). The optimal restricted spectrum imaging (RSI) model and value for high\u2010risk metabolic dysfunction\u2010associated steatohepatitis (MASH) remain unclear.<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n To optimize RSI modeling and evaluate its performance for high\u2010risk MASH.<\/jats:p>\n <\/jats:sec>\n \n Study Type<\/jats:title>\n Prospective cross\u2010sectional study.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n 96 biopsy\u2010proven MASLD participants (median age, 46\u2009years [IQR: 36\u201358]; 51 women [53.1%]), including 64 with high\u2010risk MASH.<\/jats:p>\n <\/jats:sec>\n \n Field Strength\/Sequence<\/jats:title>\n \n 3T; fat\u2010suppressed single\u2010shot echo\u2010planar imaging with multi\u2010\n b<\/jats:italic>\n \u2010value diffusion\u2010weighted imaging, EPI\u2010based MR elastography, and 3D chemical shift\u2010encoded proton density fat\u2010fraction imaging.\n <\/jats:p>\n <\/jats:sec>\n \n Assessment<\/jats:title>\n Two\u2010 to five\u2010compartment RSI models were compared using Bayesian information criterion (BIC). RSI fractions, apparent diffusion coefficient, FIB\u20104, and MRI\u2010based MASH score (MAST) were evaluated against histopathologic features and high\u2010risk MASH.<\/jats:p>\n <\/jats:sec>\n \n Statistical Tests<\/jats:title>\n \n Spearman correlation, Mann\u2013Whitney\n U<\/jats:italic>\n test, logistic regression, receiver operating characteristic analysis, DeLong test, bootstrap internal validation, decision curve analysis (thresholds, 0.20\u20130.60), and intraclass correlation coefficient (ICC).\n p<\/jats:italic>\n \u2009<\u20090.05 was significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The five\u2010compartment model showed the lowest BIC (1472.30; \u0394BIC\u2009=\u20090). RSI measurements showed excellent inter\u2010observer agreement (ICC, 0.955\u20130.994). RSI\u2010C1 (\n r<\/jats:italic>\n \u2009=\u20090.357) and RSI\u2010C2 (\n r<\/jats:italic>\n \u2009=\u20090.283) significantly correlated with steatosis; RSI\u2010C2 (\n r<\/jats:italic>\n \u2009=\u20090.273) and RSI\u2010C5 (\n r<\/jats:italic>\n \u2009=\u20090.282) with inflammation; and RSI\u2010C2 (\n r<\/jats:italic>\n \u2009=\u20090.326), RSI\u2010C4 (\n r<\/jats:italic>\n \u2009=\u20090.400), and RSI\u2010C5 (\n r<\/jats:italic>\n \u2009=\u20090.386) with fibrosis (all\n p<\/jats:italic>\n \u2009<\u20090.05). The RSI\u2010C2\u2009+\u2009C4\u2009+\u2009C5 model yielded an AUC of 0.800 for high\u2010risk MASH, without significant difference versus FIB\u20104 (AUC\u2009=\u20090.707;\n p<\/jats:italic>\n \u2009=\u20090.219) or MAST (AUC\u2009=\u20090.899;\n p<\/jats:italic>\n \u2009=\u20090.146). Across thresholds of 0.20\u20130.60, RSI mean net benefit (0.504) exceeded FIB\u20104 (0.438) but not MAST (0.559).\n <\/jats:p>\n <\/jats:sec>\n \n Data Conclusion<\/jats:title>\n RSI provides compartment\u2010specific microstructural biomarkers associated with MASLD histology and may complement noninvasive tools for high\u2010risk MASH assessment.<\/jats:p>\n <\/jats:sec>\n \n Evidence Level<\/jats:title>\n 2.<\/jats:p>\n <\/jats:sec>\n \n Technical Efficacy<\/jats:title>\n Stage 2.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jmri.70560","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:11:21Z","timestamp":1790773881000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Restricted Spectrum Imaging for Diagnosis of High\u2010Risk Metabolic Dysfunction\u2010Associated Steatohepatitis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6471-6687","authenticated-orcid":false,"given":"Jie","family":"Yuan","sequence":"first","affiliation":[{"name":"Department of Radiology Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8540-330X","authenticated-orcid":false,"given":"Huamei","family":"Yan","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwei","family":"Qin","sequence":"additional","affiliation":[{"name":"MR Research Collaboration, Shanghai United Imaging Healthcare Co., Ltd. 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