title: Measurement of spleen volume is useful for distinguishing between simple steatosis and early-stage non-alcoholic steatohepatitis.
abstract: OBJECTIVE
  Although non-alcoholic fatty liver disease (NAFLD) is now a common cause of chronic liver disease, discriminating between simple steatosis and non-alcoholic steatohepatitis (NASH), especially early-stage NASH, remains difficult. We investigated the clinical usefulness of measuring the spleen volume as a marker of early-stage NASH.
  
  
  METHODS
  We evaluated computed tomography (CT) images obtained in 84 patients with histologically diagnosed NAFLD (22 with simple steatosis, 62 with NASH with mild fibrosis [stages 1-2]). We defined the data obtained by the following formula as a spleen-body index (SBI): SBI = maximal CT axial section area of the spleen (cm(2))/body surface area (BSA) (cm(2)) x 10(4). We compared the SBI between patients with simple steatosis and those with NASH with mild fibrosis.
  
  
  RESULTS
  The mean SBI of the simple steatosis group was 15.8 +/- 3.9, while that of the NASH with mild fibrosis group was 18.7 +/- 5.7. This difference between the two groups was significant (P = 0.0314). A multiple logistic regression analysis showed that the SBI was significantly correlated with the discrimination of simple steatosis and NASH with mild fibrosis. The area under the receiver-operator curve was 0.661 for distinguishing between simple steatosis and NASH with mild fibrosis (P = 0.026, 95% confidence interval = 0.532-0.789).
  
  
  CONCLUSIONS
  Spleen enlargement may be a distinct feature of NASH, especially early-stage NASH. SBI might be a non-invasive and simple method of differentiating NASH and simple steatosis.
authors.affiliation: Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Suzuki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kirikoshi
authors.forename: Masato
authors.initials: M
authors.lastname: Yoneda
authors.forename: Hironori
authors.initials: H
authors.lastname: Mawatari
authors.forename: Koji
authors.initials: K
authors.lastname: Fujita
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Nozaki
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takahashi
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Abe
authors.forename: Masahiko
authors.initials: M
authors.lastname: Inamori
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimamura
authors.forename: Noritoshi
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kubota
authors.forename: Satoru
authors.initials: S
authors.lastname: Saito
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima