Diagnostic Value of a Computerized Hepatorenal Index for Sonographic Quantification of Liver Steatosis

Webb, Muriel; Yeshua, Hanny; Zelber‐Sagi, Shira; Santo, Erwin; Brazowski, Eli; Halpern, Zamir; Oren, Ran

doi:10.2214/ajr.07.4016

Cited by 241 publications

(247 citation statements)

References 49 publications

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“…86 Table 3 presents results of the imaging techniques used in diagnosis of NAFLD-NASH. 86,[90][91][92][93][94][95][96][97][98][99][100][101][102][103][104][105][106][107][108][109] The underlying physical principle of imaging techniques are the same between adults and children. Consequently research in both age groups could be used to approve the use of these methods in pediatric field.…”

Section: Image Studiesmentioning

confidence: 99%

“…101 Liver stiffness measurement by transient elastography is a reliable method for predicting significant liver fibrosis. [102][103][104][105][106][107][108] Discordance of transient elastography with liver pathology may be related to unsatisfactory liver biopsy specimen. 101 Magnetic resonance offers imaging and spectroscopic methods for quantification of fat with relatively high accuracy without any invasive procedures or radiation exposure.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

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Nonalcoholic fatty liver disease: a challenge for pediatricians

Widhalm

Ghods

2010

Int J Obes

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Background: Nonalcoholic fatty liver disease (NAFLD) is the most common cause of pediatric liver disease. Its prevalence is related to the growing epidemic in childhood obesity during the past decades. At present, NAFLD and nonalcoholic steatohepatitis (NASH) are increasingly recognized worldwide. In spite of alarming trend in the epidemiology in pediatric field and growing risk of end stage liver disease, there is no significant advance in its diagnosis and treatment. Aim: To provide a detailed review for diagnosis and management of NAFLD and NASH. Methods: By using Pubmed to find review articles and relevant research. Results: The prevalence ranges from at least 3% in children overall to about 50% in obese children. The noninvasive biomarkers can be used to identify NAFLD/NASH patients. Diagnostic criteria based on biochemical and immunological indicators in the high-risk group of children could prevent about half of cases from receiving an invasive test. The pharmacological and surgical interventions have shown a growing role in pediatric NAFLD. Novel treatment modalities, such as probiotics, have hardly been studied. Conclusion: Early diagnosis by using noninvasive screening methods in high-risk groups is the most effective strategy against the NAFLD. The biology of early growth and development, including hepatic metabolism, may hold the key to pediatric NAFLD. Prevention of overweight children and childhood obesity is undoubtedly the best strategy for treating NAFLD.

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Section: Image Studiesmentioning

confidence: 99%

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Nonalcoholic fatty liver disease: a challenge for pediatricians

Widhalm

Ghods

2010

Int J Obes

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“…All the indices were measured thrice directly from the frozen images using an electronic caliper. The classification of "bright liver" or HS was based on the following scale of hyperechogenicity: 0 = absent, 1 = light, 2 = moderate, 3 = severe, pointing out the difference between the densities of the liver and the right kidney [27] .…”

Section: Ultrasound Evaluationmentioning

confidence: 99%

Hepatic steatosis in overweight/obese females: Newscreening method for those at risk

Tarantino¹,

Pizza²,

Colao³

et al. 2009

WJG

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AIM:To identify which parameters could help to distinguish the "metabolically benign obesity", which is not accompanied by insulin resistance (IR) and early atherosclerosis. METHODS:Eighty two of 124 overweight/obese females formed the study population, which was divided into two groups (52 and 30 subjects, respectively) with and without IR according to a HO meostatic Metabolic Assessment (HOMA) cut-off of 2, and were studied in a cross-sectional manner. The main outcome measures were waist circumference, serum uric acid, high-density lipoprotein-cholesterol and triglycerides, alanine aminotransferase, blood pressure and the two imaging parameters, hepatic steatosis and longitudinal diameter of the spleen, which were measured in relation to the presence/absence of IR. RESULTS:A variable grade of visceral obesity was observed in all subjects with the exception of three.Obesity of a severe grade was represented more in the group of IR individuals (P = 0.01). Hepatic steatosis, revealed at ultrasound, was more pronounced in IR than in non-IR subjects (P = 0.005). The two groups also demonstrated a clear difference in longitudinal spleen diameter and blood pressure, with raised and significant values in the IR group. Metabolic syndrome was frequent in the IR group, and was not modified when adjusted for menopause (P = 0.001). At linear regression, the β values of waist circumference and body mass index predicting HOMA were 0.295, P = 0.007 and 0.41, P = 0.0001, respectively. Measures of spleen longitudinal diameter were well predicted by body mass index (BMI) values, β = 0.35, P = 0.01, and by HOMA, β = 0.41, P = 0.0001. Blood pressure was predicted by HOMA values, β = 0.39, P = 0.0001). HOMA and hepatic steatosis were highly associated (rho = 0.34, P = 0.002). Interestingly, IR patients were almost twice as likely to have hepatic steatosis as non-IR patients. Among the MS criteria, blood pressure was very accurate in identifying the presence of IR (AUROC for systolic blood pressure 0.66, cut-off 125 mm of Hg, sensibility 64%, specificity 75%; AUROC for diastolic blood pressure 0.70, cut-off 85 mm of Hg, sensibility 54.5%, specificity 75%). CONCLUSION:As health care costs are skyrocketing, reliable and mainly inexpensive tools are advisable to better define subjects who really need to lose weight.

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“…[11][12][13][14][15][16][17][18] The positive aspects of B-mode ultrasound, such as being routinely available and completely safe, make it a valuable tool in clinical settings and large population studies. [13][14][15][16][17][18][19][20][21][22][23][24] The most common B-mode ultrasound criteria reported for diffuse hepatic fatty infiltration are as follows: (1) parenchymal brightness; (2) deep-beam attenuation; (3) vascular blurring (loss of echoes from the walls of the portal veins); and (4) increasing discrepancy of echogenicity between the liver and kidney parenchyma (hepatorenal index). 1,10,15,[19][20][21][22] Among these criteria, deep-beam attenuation has presented better performance for diagnosing fatty liver disease.…”

Section: Introductionmentioning

confidence: 99%

“…[13][14][15][16][17][18][19][20][21][22][23][24] The most common B-mode ultrasound criteria reported for diffuse hepatic fatty infiltration are as follows: (1) parenchymal brightness; (2) deep-beam attenuation; (3) vascular blurring (loss of echoes from the walls of the portal veins); and (4) increasing discrepancy of echogenicity between the liver and kidney parenchyma (hepatorenal index). 1,10,15,[19][20][21][22] Among these criteria, deep-beam attenuation has presented better performance for diagnosing fatty liver disease. [25][26][27][28][29][30][31] However, conventional B-mode ultrasonography presents limitations, including subjective evaluation and operator dependency.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of a noninvasive hepatic ultrasound score for non-alcoholic fatty liver disease (NAFLD) in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

et al. 2015

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CONTEXT AND OBJECTIVE: Noninvasive strategies for evaluating non-alcoholic fatty liver disease (NAFLD) have been investigated over the last few decades. Our aim was to evaluate the diagnostic accuracy of a new hepatic ultrasound score for NAFLD in the ELSA-Brasil study. DESIGN AND SETTINGS: Diagnostic accuracy study conducted in the ELSA center, in the hospital of a public university. METHODS: Among the 15,105 participants of the ELSA study who were evaluated for NAFLD, 195 individuals were included in this sub-study. Hepatic ultrasound was performed (deep beam attenuation, hepatorenal index and anteroposterior diameter of the right hepatic lobe) and compared with the hepatic steatosis findings from 64-channel high-resolution computed tomography (CT). We also evaluated two clinical indices relating to NAFLD: the fatty liver index (FLI) and the hepatic steatosis index (HSI). RESULTS: Among the 195 participants, the NAFLD frequency was 34.4%. High body mass index, high waist circumference, diabetes and hypertriglyceridemia were associated with high hepatic attenuation and large anteroposterior diameter of the right hepatic lobe, but not with the hepatorenal index. The hepatic ultrasound score, based on hepatic attenuation and the anteroposterior diameter of the right hepatic lobe, presented the best performance for NAFLD screening at the cutoff point

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Diagnostic Value of a Computerized Hepatorenal Index for Sonographic Quantification of Liver Steatosis

Cited by 241 publications

References 49 publications

Nonalcoholic fatty liver disease: a challenge for pediatricians

Nonalcoholic fatty liver disease: a challenge for pediatricians

Hepatic steatosis in overweight/obese females: Newscreening method for those at risk

Diagnostic accuracy of a noninvasive hepatic ultrasound score for non-alcoholic fatty liver disease (NAFLD) in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

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