Fatty infiltration of the liver: analysis of prevalence, radiological and clinical features and influence on patient management

Abstract

Over a 6-year period, in 1425 adult computed tomographic studies, radiological evidence of fatty infiltration of the liver (FIL) was found in 138 patients (9.7%). Patients with FIL had a mean age +/- SD of 45.9 +/- 15.7 years and 57% were males; the majority were Saudis (73%). Most patients (95%) had one or more underlying aetiological causes. Haematological and non-haematological malignancies with or without liver involvement were the most frequently encountered aetiological factors (66% of patients). FIL contributed to hepatomegaly or was associated with abnormality in one or more of the liver function tests in 30% and 39% of patients, respectively. Assessment of the various radiological patterns showed diffuse fatty changes in 68% of patients and solitary or multiple focal changes in 9% and 22%, respectively. 13 patients (9%) showed sparing of the caudate lobe within a diffuse fatty process. Patients with diffuse FIL had significantly higher values for alkaline phosphatase (p = 0.0016) and serum asparate aminotransferase (p = 0.0251) than those who had the focal pattern. FIL in 20 patients (14%) imposed a difficulty in making an appropriate diagnosis, led to inaccurate impressions, or forced unnecessary invasive or non-invasive investigations. We conclude from our large series of patients that FIL is not uncommon in hospital practice and among those at risk should always be considered as an appropriate diagnosis.

Hepatic steatosis in Cushing's syndrome: a radiological assessment using computed tomography

“…The prevalence of hepatic steatosis in the asymptomatic general population is not well documented in the published literature, with varying results from 3.5% to 24%, as described below (13)(14)(15)(16)(17). Two postmortem studies of random deaths have reported on the prevalence of hepatic steatosis: in a study of 423 aircrew involved in fatal aircraft accidents, 66 cases (15%) had a fatty liver, 11 of which had histopathological evidence of alcohol abuse (14); in a study of 503 fatal road traffic accidents, 24% had a fatty liver and fatty change was significantly correlated with body weight and increasing age (13).…”

“…The L/S ratio is a reliable way of assessing fatty infiltration of the liver (9, 10). The CT prevalence of hepatic steatosis has been documented in a large retrospective study of unselected hospital patients in Saudi Arabia (17). A prevalence of 9.7% was identified, using an absolute attenuation value of 2 10 Hounsfield units as the definition of hepatic steatosis.…”

Esteatose hepática em mulheres obesas

“…Para alguns pesquisadores, a USG é uma técnica bastante sensível para distinguir o fígado "normal" do "anormal", com a vantagem de não ser invasivo, ter baixo custo e ausência de radiação (11)(12)(13)(14)(15).…”

“…Franzese et al (17) em 75 crianças obesas italianas, observaram que 53% tinham imagem ultra-sonográfica hepática compatível com esteatose (24% severa, 42% moderada e 34% leve), similar à freqüência que encontramos em adultos obesos (18). A freqüência de imagem por tomografia computadorizada hepática sugestiva de esteatose hepática em indivíduos normais é de cerca de 10% (15).…”

Magnitude of nonalcoholic fatty liver disease (NAFLD) and concomitant risk factors in patients with type 2 diabetes mellitus

“…Liver biopsy represents the best diagnostic test for staging liver steatosis, inflammation and fibrosis, but medical and ethical considerations limit its use in subjects with nonprogressive fatty liver conditions. 12,13 Liver ultrasonography which had a sensitivity and specificity of 83% and 100%, respectively, as compared with histologic finding as the gold standard method demonstrates a good correlation with histological findings of fatty infiltration. 14 The association of T2DM with microvascular and macrovascular complications is well established, but the association of T2DM with NAFLD as a major complication has been recently recognized.…”