Diagnostic accuracy of B-Mode ultrasound and Hepatorenal Index for graduation of hepatic steatosis in patients with chronic liver disease

Petzold, Golo; Lasser, Julian; Rühl, Janina; Bremer, Sebastian; Knoop, Richard F.; Ellenrieder, Volker; Kunsch, Steffen; Neeße, Albrecht

doi:10.1371/journal.pone.0231044

Cited by 33 publications

(43 citation statements)

References 29 publications

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“…This procedure has a high specificity for the presence of fatty liver disease but the sensitivity is insufficient for minor changes to the hepatocytes (steatosis percentage < 20 %) [20]. A quantitative determination of the sound attenuation or a computational comparison of the kidney/liver parenchyma can provide more precise results [21]. However, for steatosis screening, methods based on magnetic resonance imaging are superior to ultrasound-based methods [22].…”

Section: Diagnosing Steatosismentioning

confidence: 99%

“…As a result, both the liver contour and the visualization of the hepatic vessels, particularly thin-walled hepatic veins, are affected. Therefore, a number of authors recommend the graduation of the degree of steatosis on the basis of the attenuation of the sound signal on the B-mode image [21,24]: ▪ Grade 1 -Increased parenchymal echogenicity without the signal intensity being affected ▪ Grade II -Additional attenuation of the signal intensity while the visibility of the dorsal liver contour is maintained ▪ Grade III -Complete signal attenuation (signal loss) in the steatotic liver parenchyma. Liver contours far from the transducer and the diaphragm can no longer be differentiated.…”

Section: Diagnosing Steatosismentioning

confidence: 99%

“…Dieses Vorgehen hat eine hohe Spezifität für das Vorliegen einer Leberverfettung, die Sensitivität ist aber für gering ausgeprägte Veränderungen der Hepatozyten (Steatoseanteil < 20 %) unzureichend[20]. Eine quantitative Bestimmung der Schallabschwächung oder ein rechnerischer Vergleich des Nieren-/Leberparenchyms kann genauere Ergebnisse liefern[21]. Für das Steatose-Screening sind jedoch magnetresonanzbasierte Verfahren ultraschallbasierten…”

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Diagnostic Value of Ultrasound in Fatty Liver Disease

2021

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Hepatic steatosis is a commonly seen phenomenon in clinical practice and is the result of the accumulation of lipids in the hepatocytes. In most cases steatosis refers to nonalcoholic fatty liver disease (NAFLD), but it also occurs in other diseases of the liver parenchyma of a different etiology and is the result of the dysregulation of metabolic processes. Consequently, inflammatory processes can induce progressive fibrosis. Due to the high prevalence of fatty liver disease, a further increase in metabolic liver cirrhosis with corresponding complications can be expected in the near future. Due to its broad availability, ultrasound is particularly important, especially for the management of NAFLD. In addition to diagnosis and risk stratification, the monitoring of high-risk patients in NAFLD is becoming increasingly clinically important. Multimodality ultrasound includes B-mode and duplex methods, analysis of tissue stiffness (elastography), contrast-enhanced imaging (CEUS), and steatosis quantification. When using ultrasound in fatty liver disease, a standardized approach that takes into account the limitations of the method is essential.

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Section: Diagnosing Steatosismentioning

confidence: 99%

Section: Diagnosing Steatosismentioning

confidence: 99%

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Diagnostic Value of Ultrasound in Fatty Liver Disease

2021

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“…After examining the full text of these publications, we excluded four studies owing to unsatisfactory inclusion criteria or unsatisfactory outcome measures [Table 2]. As a consequence of this selection strategy, twelve observational studies [18,[24][25][26][27][28][29][30][31][32][33][34] comparing the diagnostic accuracy of ultrasonography to liver histology were included in the meta-analysis and were assessed for quality (as summarized in Table 3). These studies included 2921 middle-aged participants (mean age 45 ± 7 years; mean BMI 29 ± 9 kg/m 2 ), 1710 (58.5%) of whom had ≥ 5% histologically defined HS.…”

Section: Literature Search and Study Characteristicsmentioning

confidence: 99%

Diagnostic accuracy of ultrasonography for the detection of hepatic steatosis: an updated meta-analysis of observational studies

Ballestri¹,

Mantovani²,

Byrne³

et al. 2021

MTOD

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Aim: We examined the diagnostic accuracy of ultrasonography to detect any HS (defined as steatotic hepatocytes ≥ 5% on histology) and moderate-severe HS (defined as steatotic hepatocytes ≥ 30% on histology) by performing a systematic review and meta-analysis. Methods:We systematically searched PubMed, Web of Science, and Scopus databases, from January 2011 to February 2021, to identify studies conducted in adults investigating the diagnostic accuracy of ultrasonography vs. histology for detecting either ≥ 5% histologically defined HS or moderate-severe HS (≥ 30%). Meta-analysis was performed using random-effects modeling.Results: Twelve studies were included involving a total of 2921 individuals, 1710 (58.5%) of whom had HS ≥ 5% by histology. The overall sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of ultrasonography for the detection of ≥ 5% histologically defined HS, compared to histology, were 82% (95% the pooled analysis of seven studies, the overall sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of ultrasonography for the detection of ≥ 30% histologically defined HS were 85% (72%-92%), 85% (73%-93%), 5.72 (3.06-10.7), and 0.18 (0.10-0.33) , respectively. Funnel plots did not reveal any significant publication bias. Conclusion:Conventional ultrasonography allows for reliable and accurate detection of ≥ 5% histologically defined HS compared to histology. These findings call for an extensive use of conventional ultrasonography in the clinical arena.

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“…Studies have shown that the diagnosis of moderate or severe grades of liver steatosis by ultrasound is characterized by sensitivity and specificity rates of 80–91% and 87–98%, respectively. Nevertheless, these values drop to as low as 53% and 77%, respectively, when detecting steatosis of any grade [ 68 , 69 , 70 , 71 , 72 ].…”

Section: Ultrasound Based Techniquesmentioning

confidence: 99%

Usefulness of Different Imaging Modalities in Evaluation of Patients with Non-Alcoholic Fatty Liver Disease

Grąt

Rowiński

2020

Biomedicines

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Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are becoming some of the major health problems in well-developed countries, together with the increasing prevalence of obesity, metabolic syndrome, and all of their systemic complications. As the future prognoses are even more disturbing and point toward further increase in population affected with NAFLD/NASH, there is an urgent need for widely available and reliable diagnostic methods. Consensus on a non-invasive, accurate diagnostic modality for the use in ongoing clinical trials is also required, particularly considering a current lack of any registered drug for the treatment of NAFLD/NASH. The aim of this narrative review was to present current information on methods used to assess liver steatosis and fibrosis. There are several imaging modalities for the assessment of hepatic steatosis ranging from simple density analysis by computed tomography or conventional B-mode ultrasound to magnetic resonance spectroscopy (MRS), magnetic resonance imaging proton density fat fraction (MRI-PDFF) or controlled attenuation parameter (CAP). Fibrosis stage can be assessed by magnetic resonance elastography (MRE) or different ultrasound-based techniques: transient elastography (TE), shear-wave elastography (SWE) and acoustic radiation force impulse (ARFI). Although all of these methods have been validated against liver biopsy as the reference standard and provided good accuracy, the MRS and MRI-PDFF currently outperform other methods in terms of diagnosis of steatosis, and MRE in terms of evaluation of fibrosis.

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Diagnostic accuracy of B-Mode ultrasound and Hepatorenal Index for graduation of hepatic steatosis in patients with chronic liver disease

Cited by 33 publications

References 29 publications

Diagnostic Value of Ultrasound in Fatty Liver Disease

Diagnostic Value of Ultrasound in Fatty Liver Disease

Diagnostic accuracy of ultrasonography for the detection of hepatic steatosis: an updated meta-analysis of observational studies

Usefulness of Different Imaging Modalities in Evaluation of Patients with Non-Alcoholic Fatty Liver Disease

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