Which clinical and sonographic parameters may be useful to discriminate NASH from steatosis?
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.
Zardi
Enrico Maria
EM
Department of Clinical Medicine, Campus Bio-Medico University, Rome, Italy. e.zardi@unicampus.it
De Sio
Ilario
I
Ghittoni
Giorgia
G
Sadun
Beniamino
B
Palmentieri
Bruno
B
Roselli
Paola
P
Persico
Marcello
M
Caturelli
Eugenio
E
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