Sonographic hepatic-renal ratio as indicator of hepatic steatosis: comparison with (1)H magnetic resonance spectroscopy.
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.
Mancini
Marcello
M
Biostructure and Bioimaging Institute, National Council of Research (CNR), Naples, Italy. marcello.mancini@libero.it
Prinster
Anna
A
Annuzzi
Giovanni
G
Liuzzi
Raffaele
R
Giacco
Rosalba
R
Medagli
Carmela
C
Cremone
Matteo
M
Clemente
Gennaro
G
Maurea
Simone
S
Riccardi
Gabriele
G
Rivellese
Angela Albarosa
AA
Salvatore
Marco
M
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
D011522:Protons; D014280:Triglycerides