Sonographic hepatorenal ratio: A noninvasive method to diagnose nonalcoholic steatosis
- 20 September 2012
- journal article
- research article
- Published by Wiley in Journal of Clinical Ultrasound
- Vol. 41 (1), 18-25
- https://doi.org/10.1002/jcu.21994
Abstract
Purpose. To evaluate the accuracy of the sonographic hepatorenal ratio (HRR) in the diagnosis and grading of nonalcoholic steatosis, using biopsy as the reference. Methods. Ultrasound (US) and liver biopsy were performed in 42 patients with nonalcoholic fatty liver disease. Forty healthy volunteers without steatosis at US and without risk factors for nonalcoholic fatty liver disease were also studied. The HRR was obtained by dividing the mean brightness level of region‐of‐interest pixels in hepatic parenchyma by that in renal parenchyma. Needle biopsy samples (hematoxylin‐eosin stained) were classified as mild (5–33% fatty infiltration), moderate (>33–66%), or severe (>66%) steatosis. Spearman coefficient was used to evaluate the correlation between HRR and steatosis grade, analysis of variance for differences between subgroups, and receiver operating characteristic curve analysis for sensitivity and specificity. Results. Significant correlation was found between HRR and histologic steatosis (r = 0.80, p < 0.01). The HRR cutoff for predicting steatosis was ≥1.24 (sensitivity, 92.7%; specificity, 92.5%). The mean ± SD HRRs in controls and steatosis subgroups were control 1.09 ± 0.13, mild 1.46 ± 0.24, moderate 1.52 ± 0.27, severe 2.04 ± 0.3 and were significantly different from each other except between mild and moderate steatosis subgroups. Conclusions. The HRR is a noninvasive, objective, and simple method that could be used to diagnose and grade hepatic steatosis. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound 2013This publication has 38 references indexed in Scilit:
- Noncirrhotic human nonalcoholic fatty liver disease induces portal hypertension in relation to the histological degree of steatosisEuropean Journal of Gastroenterology & Hepatology, 2010
- Pediatric nonalcoholic fatty liver disease: A clinical and laboratory challengeWorld Journal of Hepatology, 2010
- Advances in pediatric nonalcoholic fatty liver diseaseHepatology, 2009
- Liver steatosis in patients with chronic hepatitis B infection: host and viral risk factorsEuropean Journal of Gastroenterology & Hepatology, 2009
- Diagnosis of Nonalcoholic Fatty Liver Disease: Invasive versus NoninvasiveSeminars in Liver Disease, 2008
- Cirrhosis and liver failure in nonalcoholic fatty liver disease: Molehill or mountain?Hepatology, 2008
- 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
- Nonalcoholic Fatty Liver Disease: From Steatosis to CirrhosisHepatology, 2006
- Design and validation of a histological scoring system for nonalcoholic fatty liver diseaseHepatology, 2005