Diagnostic accuracy of B-Mode ultrasound and Hepatorenal Index for graduation of hepatic steatosis in patients with chronic liver disease
Open Access
- 1 May 2020
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 15 (5), e0231044
- https://doi.org/10.1371/journal.pone.0231044
Abstract
The aim of our study was to evaluate the diagnostic accuracy of B-Mode ultrasound and Hepatorenal Index (HRI) by high-end devices for the detection and classification of hepatic steatosis in patients with various causes of chronic liver disease (CLD). We retrospectively enrolled patients with CLD who underwent liver biopsy and baseline ultrasound between March 2016 and May 2019. Sonographic graduation of steatosis (0°-III°) using B-Mode criteria and HRI were correlated with the histological graduation (S0 (33–66%) and S3 (>66%). Interobserver agreement was calculated. 157 patients were evaluated. B-Mode ultrasound had a sensitivity of 75.6% and a specificity of 76.0% to differentiate between steatosis and no steatosis (AUROC 0.758). Using B-Mode criteria for advanced steatosis (≥II°), specificity for presence of histological steatosis was ≥98.7%. For detection of advanced steatosis (≥S2), sensitivity of B-mode criteria was 90.9%. In a subgroup of patients with advanced liver fibrosis, sensitivity of B-mode criteria was 95.0% for detection of advanced steatosis (S≥2). A HRI cut-off-value of 1.46 differentiates between patients with steatosis and patients without steatosis with a sensitivity of 42.7% and a specificity of 90.7% (AUROC 0.680). Interobserver agreement of both B-Mode and HRI was good to excellent. B-Mode ultrasound using high-end devices is an excellent method to detect advanced steatosis in patients with various CLD. For diagnosis of mild steatosis, modern ultrasound devices may have higher sensitivity but at the expense of specificity. Stage of fibrosis and etiology of CLD seem not to impact on diagnostic accuracy. The additional calculation of HRI seems to have no additional benefit with regard to detect or grade hepatic steatosis in our study population.Keywords
This publication has 28 references indexed in Scilit:
- Hepatorenal Index as an Accurate, Simple, and Effective Tool in Screening for SteatosisAmerican Journal of Roentgenology, 2012
- Sonographic hepatorenal ratio: A noninvasive method to diagnose nonalcoholic steatosisJournal of Clinical Ultrasound, 2012
- Prevalence and associated metabolic factors of nonalcoholic fatty liver disease in the general population from 2009 to 2010 in Japan: a multicenter large retrospective studyThe Esophagus, 2012
- Non-invasive assessment of hepatic steatosis: Prospective comparison of the accuracy of imaging examinationsJournal of Hepatology, 2010
- Diagnostic Value of a Computerized Hepatorenal Index for Sonographic Quantification of Liver SteatosisAmerican Journal of Roentgenology, 2009
- Fatty liver disease in severe obese patients: Diagnostic value of abdominal ultrasoundWorld Journal of Gastroenterology, 2008
- Interobserver and Intraobserver Variability in the Sonographic Assessment of Fatty LiverAmerican Journal of Roentgenology, 2007
- The role of bright liver echo pattern on ultrasound B-mode examination in the diagnosis of liver steatosisDigestive and Liver Disease, 2006
- Design and validation of a histological scoring system for nonalcoholic fatty liver diseaseHepatology, 2005
- Bioptische Diagnostik der chronischen HepatitisDer Pathologe, 2004