title: Sonographic hepatic-renal ratio as indicator of hepatic steatosis: comparison with (1)H magnetic resonance spectroscopy.
abstract: The aim of this study was to determine the diagnostic performance of ultrasound (US) in the quantitative assessment of steatosis by comparison with proton magnetic resonance spectroscopy ((1)H-MRS) as a reference standard. Three liver echo-intensity indices were derived: US hepatic mean gray level, hepatic-renal echo-intensity ratio (H/R), and hepatic-portal blood echo-intensity ratio. The (1)H-MRS degree of steatosis was determined as percentage fat by wet weight. Regression equations were used to estimate quantitatively hepatic fat content. The hepatic fat content by (1)H-MRS analysis ranged from 0.10% to 28.9% (median value, 4.8%). Ultrasound H/R was correlated with the degree of steatosis on (1)H-MRS (R(2)= 0.92; P < .0001), whereas no correlation with (1)H-MRS was found for hepatic mean gray level and hepatic-portal blood echo-intensity ratio. A receiver operating characteristic curve identified the H/R of 2.2 as the best cutoff point for the prediction of (1)H-MRS of at least 5%, yielding measures of sensitivity and specificity of 100% and 95%, respectively. In this pilot study, US H/R exhibits high sensitivity and specificity for detecting liver fatty changes. Our results indicate that quantitative evaluation of hepatic fat content can be performed using US H/R and could therefore be a valuable analytic tool in clinical investigation.
authors.affiliation: Biostructure and Bioimaging Institute, National Council of Research (CNR), Naples, Italy. marcello.mancini@libero.it
authors.forename: Marcello
authors.initials: M
authors.lastname: Mancini
authors.forename: Anna
authors.initials: A
authors.lastname: Prinster
authors.forename: Giovanni
authors.initials: G
authors.lastname: Annuzzi
authors.forename: Raffaele
authors.initials: R
authors.lastname: Liuzzi
authors.forename: Rosalba
authors.initials: R
authors.lastname: Giacco
authors.forename: Carmela
authors.initials: C
authors.lastname: Medagli
authors.forename: Matteo
authors.initials: M
authors.lastname: Cremone
authors.forename: Gennaro
authors.initials: G
authors.lastname: Clemente
authors.forename: Simone
authors.initials: S
authors.lastname: Maurea
authors.forename: Gabriele
authors.initials: G
authors.lastname: Riccardi
authors.forename: Angela Albarosa
authors.initials: AA
authors.lastname: Rivellese
authors.forename: Marco
authors.initials: M
authors.lastname: Salvatore
mesh_terms: D000273:Adipose Tissue / Q000737:chemistry / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D005234:Fatty Liver / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007668:Kidney / Q000737:chemistry / Q000000981:diagnostic imaging*; D016014:Linear Models; D008099:Liver / Q000737:chemistry / Q000000981:diagnostic imaging*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011522:Protons; D012372:ROC Curve; D014280:Triglycerides / Q000032:analysis / Q000378:metabolism; D014463:Ultrasonography
chemical_list: D011522:Protons; D014280:Triglycerides