title: MDCT classification of steatotic liver: a multicentric analysis.
abstract: OBJECTIVE
  Fatty liver disease is the most common cause of chronic liver disease in the western world. The aim of this study was to analyze steatotic liver characteristics using multidetector row computed tomography (CT) to identify reliable criteria to identify the steatosis and quantify its severity.
  
  
  METHODS
  Multiphasic CT scans of 51 consecutive adults (36 men, mean age 57.1±9.9 years), who underwent ultrasound-guided liver biopsy, were analyzed. In all patients, the Hounsfield units (HU) value was determined for each hepatic segment and for each contrast phase. Also, the splenic attenuation was quantified and the differences in the liver-spleen (DLS). Steatosis was graded according its severity into four grades. Receiver operating characteristic (ROC) curve analysis was carried out to calculate the sensitivity and specificity for the specific HU threshold. Pearson's ρ correlation was also calculated. A P value of 0.05 was considered statistically significant.
  
  
  RESULTS
  We found that 14 individuals (10 men, mean age 56±9.8 years) did not have hepatic steatosis. Only the nonenhanced CT scans showed a statistically significant association with liver steatosis (with the only exception of region-of-interest selected in the Couinaud segment VII, where a P value of 0.0513 was obtained). For grades 1, 2, 3, and 4, we identified 50, 45, 35, and 20 HU as thresholds. A statistically significant association was found between steatosis and DLS in the nonenhanced and the arterial phase (P=0.0192 and 0.001, respectively).
  
  
  CONCLUSIONS
  The result of our study indicates that the nonenhanced value of the liver can be used to identify steatosis of the liver and to grade its severity. Moreover, the DLS in the arterial phase represents another reliable parameter.
authors: aDepartment of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, Cagliari bDepartment of Radiological Sciences cDepartment of Molecular Medicine, University of Rome La Sapienza dDepartment of Radiological Sciences, Oncology, and Pathology, University of Rome Sapienza-Polo Pontino, Rome, Italy.
authors: Luca
authors: L
authors: Saba
authors: Michele
authors: M
authors: di Martino
authors: Sandro
authors: S
authors: Bosco
authors: Maurizio
authors: M
authors: Del Monte
authors: Carlo Nicola
authors: CN
authors: de Cecco
authors: Valentina
authors: V
authors: Lombardo
authors: Mario
authors: M
authors: Piga
authors: Carlo
authors: C
authors: Catalano
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods; D005234:Fatty Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013154:Spleen / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods