Noninvasive Evaluation of Graft Steatosis in Living Donor Liver Transplantation

Iwasaki, Masashi; Takada, Yasutsugu; Hayashi, Michihiro; Minamiguchi, Sachiko; Haga, Hironori; Maetani, Yoji; Fujii, Kazumichi; Kiuchi, Tetsuya; Tanaka, Kōichi

doi:10.1097/01.tp.0000140499.23683.0d

Cited by 210 publications

(173 citation statements)

References 21 publications

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“…Re l a t i o n s h i p s b e t we e n Ad i p o s i t y , S e r u m L i p i d s , I n s u l i n Re s i s t a n c e , a n d Cl i n i c a l B a c k g r o u n d F a c t o r s E v a l u a t e Table 2). We were able to further show that even after adjustment for age, gender and HbA1c, the serum BChE activity was still correlated significantly with the HDL-C, TG and LDL-C (Table 3), confirming the previously reported association between the serum BChE activity and the lipid profile and hepatic fat content (6,7,9). We also examined whether the changes in the serum BChE activity were associated with changes in the L/S ratio, VFA and SFA at 1 year after the initial hospitalization in the patients ( We had previously demonstrated an association of the serum ferritin and serum CRP concentrations with the parameters of adiposity and degree of insulin resistance (16,17) …”

Section: T a B L E 3 Re L A T I O N S H I P S B E T We E N Ad I P Osupporting

confidence: 78%

“…(6)(7)(8)(9)(10). On the other hand, the relationship of radiologically measured abdominal fat accumulation and hepatic fat content to metabolic risk factors for atherosclerosis has been intensively investigated, and both the visceral fat area (VFA) and hepatic fat content are now recognized to be correlated with the plasma TG level and glucose utilization (11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

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Serum Butyrylcholinesterase is Strongly Associated with Adiposity, the Serum Lipid Profile and Insulin Resistance

et al. 2007

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Objective We investigated the association between the serum butyrylcholinesterase (BChE) activity and parameters of adiposity, insulin resistance and the serum lipid profile, including the serum levels of triglyceride (TG), HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C) Results Serum BChE activity was significantly correlated with various indices of adiposity, including the waist circumference, L/S ratio, visceral fat area (VFA), subcutaneous fat area (SFA) and BMI, and also with the TG, HDL-C, LDL-C and HOMA-R, in the entire subject population. Even after adjustment for five variables, namely, age, gender, HbA1c, CRP and serum ferritin (the serum levels of ferritin and CRP have been reported to be associated with adiposity and insulin resistance), the serum BChE activity was still correlated with the waist circumference, L/S ratio, VFA, SFA, BMI, TG, HDL-C, LDL-C and

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Section: T a B L E 3 Re L A T I O N S H I P S B E T We E N Ad I P Osupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Serum Butyrylcholinesterase is Strongly Associated with Adiposity, the Serum Lipid Profile and Insulin Resistance

et al. 2007

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“…However, the absence of hepatic steatosis was not histopathologically confi rmed in these studies. Although there have been several histologically correlated studies of the CT criteria used to diagnose hepatic steatosis (10)(11)(12), the results of these investigations have been specifi c for the diagnosis of moderate to severe macrovesicular hepatic steatosis during hepatic donor evaluation and thus are not applicable to various other clinical settings.…”

Section: Study Subjectsmentioning

confidence: 99%

Biopsy-proven Nonsteatotic Liver in Adults: Estimation of Reference Range for Difference in Attenuation between the Liver and the Spleen at Nonenhanced CT

et al. 2011

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Purpose:To establish the reference range for hepatic attenuation minus splenic attenuation difference (CT L 2 S ) values on nonenhanced computed tomographic (CT) images obtained in adults with a biopsy-proved nonsteatotic liver and determine the CT L 2 S criterion for diagnosing hepatic steatosis. Materials and Methods:This retrospective study was institutional review board approved, and all subjects had provided written informed consent. The CT L 2 S was measured in 315 liver donor candidates (207 men, 108 women; mean age, 31.5 years 6 10.1 [standard deviation]) who underwent nonenhanced CT of the liver and subsequent ultrasonographically guided liver biopsy on the same day. Nonenhanced liver CT was performed with a 16-section multidetector scanner in 154 individuals and with a 64-section multidetector scanner in 161 individuals. Biopsy specimens were analyzed for degree of hepatic steatosis and iron deposition. The CT L 2 S reference range was determined according to Clinical and Laboratory Standards Institute guideline C28-A3 in individuals with a histologically proved nonsteatotic liver. The sensitivity of nonenhanced CT for the diagnosis of 5% or greater and 30% or greater hepatic steatosis with use of the lower limit of the reference range as the diagnostic cutoff was determined. The effects of subject age and sex, CT scanner type, and hepatic iron on the CT L 2 S were evaluated by using multiple linear regression analysis. Results:Ninety-six subjects (48 men, 48 women) were found to have a histologically proved nonsteatotic liver, with an estimated reference range for CT L 2 S values of 1-18 HU. With a CT L 2 S of less than 1 HU as the criterion for hepatic steatosis, the sensitivities of nonenhanced CT for 5% or greater and 30% or greater hepatic steatosis were 18.6% (29 of 156 subjects) and 67 % (26 of 39 subjects), respectively. Subject age had a signifi cant but negligible effect on CT L 2 S (0.076-HU increase per year of age, P = .009), subject sex and scanner type had no effects on CT L 2 S , and hepatic iron deposition signifi cantly increased the CT L 2 S (1.434-HU increase per increase in iron deposition grade, P = .011). Conclusion:The histologically proved reference range of CT L 2 S values for nonsteatotic livers was 1-18 HU. A CT L 2 S of less than 1 HU could be used as a conservative criterion for diagnosing hepatic steatosis with nonenhanced CT more consistently.q RSNA, 2011

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“…The spleen-to-liver attenuation ratio, or the difference between the attenuation of the spleen and liver, has been proposed to evaluate hepatic steatosis [9,10]. Some reports have introduced the measurement of the same image with 2 different kVp values [11,12].…”

Section: Introductionmentioning

confidence: 99%

Relationship Between Ultrasound Backscattered Statistics and the Concentration of Fatty Droplets in Livers: An Animal Study

Lee

Jeng

et al. 2013

Ultrasound in Medicine & Biology

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Ultrasound grayscale B-mode imaging is the most frequently used modality for examining fatty liver. Different concentrations and arrangements of fatty droplets in the liver may produce different statistical distributions of ultrasound backscatter signals, which may be treated as a useful clue for assessing the stage of fatty liver. To verify this point, we investigate the relationship between changes in backscattered statistics and the concentration of fatty droplets in the liver. Fatty liver was induced in rats fed a methionine-choline-deficient diet. Livers were excised from rats for in vitro ultrasound scanning using a single-element transducer. The envelopes of the acquired raw ultrasound signals were used for the analysis of the backscattered statistics by ultrasound Nakagami parametric imaging, which has been shown as a reliable tool to model the statistical distribution of ultrasound backscatter signals. Histological analyses and the measurements of triglyceride and cholesterol in the rat liver were conducted for comparison with the Nakagami parameter. Results show that the ultrasound Nakagami parameter has an excellent correlation with the concentration of fatty droplets, demonstrating that ultrasound backscatter statistics depend on the degree of fatty liver in rats.

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Noninvasive Evaluation of Graft Steatosis in Living Donor Liver Transplantation

Abstract: L/S ratio calculated from preoperative CT can be a useful tool to discriminate hepatic macrovesicular steatosis. Based on the present results, the optimal cut-off value for L/S ratio to exclude more than moderate steatosis would be 1.1.

Cited by 210 publications

References 21 publications

Serum Butyrylcholinesterase is Strongly Associated with Adiposity, the Serum Lipid Profile and Insulin Resistance

Serum Butyrylcholinesterase is Strongly Associated with Adiposity, the Serum Lipid Profile and Insulin Resistance

Biopsy-proven Nonsteatotic Liver in Adults: Estimation of Reference Range for Difference in Attenuation between the Liver and the Spleen at Nonenhanced CT

Relationship Between Ultrasound Backscattered Statistics and the Concentration of Fatty Droplets in Livers: An Animal Study

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