title: Which clinical and sonographic parameters may be useful to discriminate NASH from steatosis?
abstract: BACKGROUND
  The natural history of nonalcoholic steatohepatitis (NASH) includes the passage through steatosis.
  
  
  OBJECTIVE
  To retrospectively evaluate the usefulness of sonographic parameters compared to histological diagnosis when differentiating steatosis from NASH.
  
  
  METHODS
  This retrospective study reviewed records of patients with steatosis from databases of our Departments, selecting only those who had been diagnosed by sonography and liver biopsy [64 males (63.82%); 30 females (36.18%)].
  
  
  RESULTS
  Attenuation of the echo amplitude (P<0.05; odds ratio (OR): 3.43; confidence interval (CI): 1.02-11.57), focal fat sparing (P<0.05; OR: 3; CI: 1.02-11.88) and splenic diameter (P<0.05; OR: 1.66; CI: 1.04-3.26) were independent predictors of NASH. A significantly higher association of attenuation of the echo amplitude, enlarged splenic diameter, and presence of focal fat sparing was observed in NASH patients (P<0.01).
  
  
  CONCLUSIONS
  It is very difficult to build a predictive system to distinguish NASH from steatosis based on sonographic scores. However, it is already possible to differentiate NASH from steatosis by combining 3 simple sonographic parameters: attenuation of the echo amplitude, enlarged splenic diameter, and presence of focal fat sparing.
authors.affiliation: Department of Clinical Medicine, Campus Bio-Medico University, Rome, Italy. e.zardi@unicampus.it
authors.forename: Enrico Maria
authors.initials: EM
authors.lastname: Zardi
authors.forename: Ilario
authors.initials: I
authors.lastname: De Sio
authors.forename: Giorgia
authors.initials: G
authors.lastname: Ghittoni
authors.forename: Beniamino
authors.initials: B
authors.lastname: Sadun
authors.forename: Bruno
authors.initials: B
authors.lastname: Palmentieri
authors.forename: Paola
authors.initials: P
authors.lastname: Roselli
authors.forename: Marcello
authors.initials: M
authors.lastname: Persico
authors.forename: Eugenio
authors.initials: E
authors.lastname: Caturelli
mesh_terms: D000328:Adult; D001706:Biopsy; D003937:Diagnosis, Differential; D005234:Fatty Liver / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D012189:Retrospective Studies; D013154:Spleen / Q000378:metabolism; D014463:Ultrasonography