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J Ultrasound Med. 2013 Feb;32(2):229-35.

Value of the ultrasound attenuation index for noninvasive quantitative estimation of hepatic steatosis.

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  • 1Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

OBJECTIVES:

To assess the value of the ultrasound (US) attenuation index for noninvasive estimation of hepatic steatosis and determine its optimal cutoff value for severe steatosis in potential living liver donors.

METHODS:

Two hundred forty potential donors underwent US-guided biopsy. The target site was scanned at 4 and 8 MHz. On the sonogram, the observer drew 3 × 3-mm square regions of interest in superficial (3-cm) and deep (5-cm) areas. The attenuation index was defined as the difference between superficial and deep echogenicity/superficial echogenicity × 100. On biopsy specimens, replacement of hepatic parenchyma was evaluated on a percentage scale. Severe steatosis was defined as macrovesicular fatty change of 30% or greater. Spearman rank correlation (ρ) was used to determine correlation coefficients between the attenuation index and steatosis degree; receiver operating characteristic analysis was performed to determine the optimal attenuation index cutoff value for severe steatosis.

RESULTS:

The median steatosis degree was 3% (interquartile range [IQR], 0%-10%). Severe steatosis was found in 10 donors. The attenuation index ranged from -27.4 to 36.6 (median, 4.0; IQR, -1.6-10.4) at 4 MHz and -18.0 to 78.1 (median, 14.5; IQR, 7.2-21.9) at 8 MHz. There was a minimal positive correlation between steatosis and the attenuation index at 4 MHz (total steatosis: ρ = 0.339; P < .001; macrovesicular steatosis: ρ = 0.360; P < .001). However, there was a significant moderate correlation between steatosis and the attenuation index at 8 MHz (total steatosis: ρ = 0.669; P < .001; macrovesicular steatosis: ρ = 0.645; P < .001). The optimal attenuation index cutoff value for severe steatosis at 8 MHz was 31.0.

CONCLUSIONS:

The US attenuation index at 8 MHz is a useful indicator for noninvasive quantitative estimation of hepatic steatosis and diagnosis of severe steatosis in potential living liver donors.

PMID:
23341377
[PubMed - indexed for MEDLINE]
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