Difference between liver and spleen CT numbers in the normal adult: its usefulness in predicting the presence of diffuse liver disease.

Piekarski, Janusz; Goldberg, H I; Royal, Stuart A.; Axel, Leon; Moss, Albert A.

doi:10.1148/radiology.137.3.6934563

Cited by 276 publications

(183 citation statements)

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“…However, this does not seem to be a good method, because the liver is metabolically ve r y a c t ive a n d i t s e ch o g e n i c i t y e x h i b i t s h i g h variance [15,16] . The concurrence of fatty pancreas and fatty liver on sonography was very high in our data (67.9%).…”

Section: Discussionmentioning

confidence: 99%

Clinical implications of fatty pancreas: Correlations between fatty pancreas and metabolic syndrome

Lee¹,

Kim²,

Jun³

et al. 2009

WJG

229

277

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AIM:To investigate the clinical implications of lipid deposition in the pancreas (fatty pancreas). METHODS:The subjects of this study were 293 patients who had undergone abdominal computed tomography (CT) and sonography. Fatty pancreas was diagnosed by sonographic findings and subdivided into mild, moderate, and severe fatty pancreas groups comparing to the retroperitoneal fat echogenicity. RESULTS:Fatty pancreas was associated with higher levels for visceral fat, waist circumference, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol, triglyceride, high density lipoprotein, free fatty acid, γ-GTP, insulin, and the homeostasis model assessment of insulin resistance (HOMA-IR) than the control group (P < 0.05). HOMA-IR, visceral fat, triglyceride, and ALT also tended to increase with the degree of fat deposition in the pancreas on sonography. In a multivariate logistic regression analysis, HOMA-IR, visceral fat, and ALT level were independently related to fatty pancreas after adjustment for age, body mass index, and lipid profile. The incidence of metabolic syndrome in the fatty pancreas group was significantly higher than in the control group, and the numbers of metabolic syndrome parameters were significantly higher in the fatty pancreas group (P < 0.05).CONCLUSION: Sonographic fatty pancrease showed higher insulin resistance, visceral fat area, triglyceride, and ALT levels than normal pancreases. Fatty pancreas also showed a strong correlation with metabolic syndrome.

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Section: Discussionmentioning

confidence: 99%

Clinical implications of fatty pancreas: Correlations between fatty pancreas and metabolic syndrome

Lee¹,

Kim²,

Jun³

et al. 2009

WJG

229

277

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“…Hepatic steatosis is primarily found incidentally, after the detection of a mild elevation in serum aminotransferase levels or at imaging examinations such as abdominal computed tomography (CT) and ultrasonography (US) performed for other purposes. Nonenhanced CT has long been used to evaluate hepatic steatosis on the basis of the inverse relationship between the amount of hepatic fat and the hepatic attenuation at CT, with CT measurements typically standardized as the hepatic attenuation minus splenic attenuation difference (CT L 2 S ) ( 3,4 ). Ironically, however, despite the widespread use of this approach, the cutoff CT L 2 S for nonenhanced CT images used to distinguish steatotic livers from nonsteatotic livers has not been defi nitively determined, with published studies involving…”

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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“…Previous studies have shown a strong correlation between the CT attenuation values of the liver and the extent of fatty infiltration of the liver as measured by liver biopsy [14,15]. The ratio of the CT attenuation value of the liver to that of the spleen (L/S ratio) has also been used for quantitative estimation of the hepatic fat content, with an L/S ratio of <1 being considered to represent fatty liver [14].…”

Section: Assessment Of the Hepatic Fat Contentmentioning

confidence: 99%

Relationship between the Serum Concentrations of C-reactive Protein and Parameters of Adiposity and Insulin Resistance in Patients with Type 2 Diabetes Mellitus

et al. 2006

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Abstract. Serum C-reactive protein (CRP) concentrations have been reported to be associated with body fat, especially visceral fat accumulation, but most studies up to now have been conducted on non-diabetic subjects. In this study, we investigated the association between the serum CRP concentrations and parameters of adiposity and insulin resistance in both Japanese type 2 diabetes patients and non-diabetic subjects. A total of 248 Japanese subjects (140 type 2 diabetes patients and 108 non-diabetic subjects) were enrolled for the study. The degree of insulin resistance was estimated by the homeostasis model assessment (HOMA-R) method. Fat accumulation was evaluated by measuring visceral and subcutaneous fat areas at the level of the umbilicus in abdominal CT scans. To assess hepatic fat content, the ratio of CT attenuation value of the liver to that of the spleen (L/S ratio) was calculated. Serum CRP was found to be significantly correlated with various indices of adiposity, including L/S ratio, visceral fat area (VFA), subcutaneous fat area (SFA), and HOMA-R, in both the diabetic patients and the non-diabetic subjects. After adjustment for five variables (age, gender, serum CRP, HbA1c, and smoking), serum CRP was still significantly correlated with L/S ratio, VFA, SFA, and HOMA-R in the diabetic patients. We also found that changes in serum CRP concentrations were correlated with changes in the VFA and SFA at 1 year after the baseline in 24 diabetic patients. We conclude that serum CRP may be closely related to the degree of liver steatosis and visceral fat accumulation in Japanese type 2 diabetes mellitus patients.

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Difference between liver and spleen CT numbers in the normal adult: its usefulness in predicting the presence of diffuse liver disease.

Cited by 276 publications

References 0 publications

Clinical implications of fatty pancreas: Correlations between fatty pancreas and metabolic syndrome

Clinical implications of fatty pancreas: Correlations between fatty pancreas and metabolic syndrome

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 the Serum Concentrations of C-reactive Protein and Parameters of Adiposity and Insulin Resistance in Patients with Type 2 Diabetes Mellitus

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