Comparison of Ultrasound and Unenhanced CT for diagnosis of Hepatic Steatosis
Article Sidebar
Main Article Content
Abstract
Background: Hepatic steatosis, characterized by pathologically increased fat deposition in the liver, is a growing health concern, with Non-Alcoholic Fatty Liver Disease (NAFLD) being the most common manifestation. This condition, which may escalate to cirrhosis and steatohepatitis, underscores the need for effective diagnostic strategies. Various non-invasive imaging techniques are pivotal in detecting hepatic steatosis (HS).
Objective: The aim of this study was to compare the efficacy of ultrasound and unenhanced CT in the diagnosis of hepatic steatosis, to determine the most reliable non-invasive imaging technique for early detection.
Methods: A cross-sectional study was conducted at the Radiological Department of Combined Military Hospital (CMH), Lahore, using a convenience sampling method from April to June 2023. The study involved 100 participants who underwent both ultrasound (USG) and CT scans. Data collection was facilitated through structured performa, and the analysis was executed using SPSS version 26.
Results: The study diagnosed hepatic steatosis through both USG and CT scans. Ultrasound assessments revealed that 23% of patients had Grade I HS, 38% had Grade II, and 20% had Grade III. Notably, 19% of the ultrasound examinations showed no signs of HS. In contrast, CT imaging results indicated 24% of participants had no disease with an L/S index greater than 1, while 62% presented with an L/S index between 0.5 to 1, indicative of HS. A critical finding was that 14% were diagnosed with Grade III steatosis, progressing to cirrhosis with an L/S index of less than 0.5. Discrepancies between imaging modalities were highlighted as 20% of patients displayed smooth liver parenchyma on USG contrasted with irregular textures on CT scans.
Conclusion: Ultrasound emerges as a viable initial imaging modality for diagnosing hepatic steatosis in early stages due to its accessibility and non-invasiveness. However, for precise quantification of liver fat content, unenhanced CT scans provide superior accuracy. Such insights direct clinicians towards a tailored approach in the management of HS.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Xie L, Wen K, Li Q, Huang C-C, Zhao J-L, Zhao Q-H, et al. CD38 deficiency protects mice from high fat diet-induced nonalcoholic fatty liver disease through activating NAD+/sirtuins signaling pathways-mediated inhibition of lipid accumulation and oxidative stress in hepatocytes. International Journal of Biological Sciences. 2021;17(15):4305.
Lewis LC, Chen L, Hameed LS, Kitchen RR, Maroteau C, Nagarajan SR, et al. Hepatocyte mARC1 promotes fatty liver disease. JHEP Reports. 2023;5(5):100693.
Heeren J, Scheja L. Metabolic-associated fatty liver disease and lipoprotein metabolism. Molecular metabolism. 2021;50:101238.
Zhuge Q, Zhang Y, Liu B, Wu M. Blueberry polyphenols play a preventive effect on alcoholic fatty liver disease C57BL/6 J mice by promoting autophagy to accelerate lipolysis to eliminate excessive TG accumulation in hepatocytes. Ann Palliat Med. 2020;9:1045-54.
Goyal A, Arora H, Arora S. Prevalence of fatty liver in metabolic syndrome. Journal of Family Medicine and Primary Care. 2020;9(7):3246.
Abdel-Rahman RF. Non-alcoholic fatty liver disease: epidemiology, pathophysiology and an update on the therapeutic approaches. Asian Pacific Journal of Tropical Biomedicine. 2022;12(3):99-114.
Broussard S, Eaglebarger J. IMPLEMENTING A PRESCREENING PROCESS TO FULLY ASSESS RISK FACTORS AND OUTCOMES ASSOCIATED WITH OBESITY AND HEPATIC STEATOSIS TO PREVENT CIRRHOSIS. 2023.
Singh K, Dahiya D, Kaman L, Das A. Prevalence of non-alcoholic fatty liver disease and hypercholesterolemia in patients with gallstone disease undergoing laparoscopic cholecystectomy. Polish Journal of Surgery. 2020;92(1):18-22.
Mumtaz S, Schomaker N, Von Roenn N. Pro: Noninvasive imaging has replaced biopsy as the gold standard in the evaluation of nonalcoholic fatty liver disease. Clinical Liver Disease. 2019;13(4):111.
Pirmoazen AM, Khurana A, El Kaffas A, Kamaya A. Quantitative ultrasound approaches for diagnosis and monitoring hepatic steatosis in nonalcoholic fatty liver disease. Theranostics. 2020;10(9):4277.
Grąt K, Grąt M, Rowiński O. Usefulness of different imaging modalities in evaluation of patients with non-alcoholic fatty liver disease. Biomedicines. 2020;8(9):298.
Dardanelli EP, Orozco ME, Oliva V, Lutereau JF, Ferrari FA, Bravo MG, et al. Ultrasound attenuation imaging: a reproducible alternative for the noninvasive quantitative assessment of hepatic steatosis in children. Pediatric Radiology. 2023:1-11.
Trujillo MJ, Chen J, Rubin JM, Gao J. Non-invasive imaging biomarkers to assess nonalcoholic fatty liver disease: A review. Clinical Imaging. 2021;78:22-34.
Kim HN, Jeon HJ, Choi HG, Kwon IS, Rou WS, Lee JE, et al. CT-based Hounsfield unit values reflect the degree of steatohepatitis in patients with low-grade fatty liver disease. BMC gastroenterology. 2023;23(1):77.
Niehoff JH, Woeltjen MM, Saeed S, Michael AE, Boriesosdick J, Borggrefe J, et al. Assessment of hepatic steatosis based on virtual non-contrast computed tomography: Initial experiences with a photon counting scanner approved for clinical use. European Journal of Radiology. 2022;149:110185.
Ullah R, Zaman A, Khan A, Khan MI, Rakha ZA, Mehmood SA. Early Detection of Nonalcholic Fatty Liver (NAFLD) on Ultrasound. Pakistan Journal of Medical & Health Sciences. 2022;16(08):966-.
Rafaqat S, Sattar A, Khalid A, Rafaqat S. Role of liver parameters in diabetes mellitus–a narrative review. Endocrine Regulations. 2023;57(1):200-20.
Guan X, Chen Y-c, Xu H-x. New horizon of ultrasound for screening and surveillance of non-alcoholic fatty liver disease spectrum. European Journal of Radiology. 2022:110450.
Martinou E, Pericleous M, Stefanova I, Kaur V, Angelidi AM. Diagnostic modalities of non-alcoholic fatty liver disease: from biochemical biomarkers to multi-omics non-invasive approaches. Diagnostics. 2022;12(2):407.
Gupta P, Dutta U, Rana P, Singhal M, Gulati A, Kalra N, et al. Gallbladder reporting and data system (GB-RADS) for risk stratification of gallbladder wall thickening on ultrasonography: an international expert consensus. Abdominal Radiology. 2022:1-12.
Bozic D, Podrug K, Mikolasevic I, Grgurevic I. Ultrasound Methods for the Assessment of Liver Steatosis: A Critical Appraisal. Diagnostics. 2022;12(10):2287.
Chen BR, Pan CQ. Non-invasive assessment of fibrosis and steatosis in pediatric non-alcoholic fatty liver disease. Clinics and Research in Hepatology and Gastroenterology. 2022;46(1):101755.
Yip TC-F, Lyu F, Lin H, Li G, Yuen P-C, Wong VW-S, et al. Non-invasive biomarkers for liver inflammation in non-alcoholic fatty liver disease: present and future. Clinical and Molecular Hepatology. 2023;29(Suppl):S171.
Abhisheka B, Biswas SK, Purkayastha B, Das D, Escargueil A. Recent trend in medical imaging modalities and their applications in disease diagnosis: a review. Multimedia Tools and Applications. 2023:1-36.
Vilalta A, Gutiérrez JA, Chaves S, Hernández M, Urbina S, Hompesch M. Adipose tissue measurement in clinical research for obesity, type 2 diabetes and NAFLD/NASH. Endocrinology, Diabetes & Metabolism. 2022;5(3):e00335.
Klinkhammer BM, Lammers T, Mottaghy FM, Kiessling F, Floege J, Boor P. Non-invasive molecular imaging of kidney diseases. Nature Reviews Nephrology. 2021;17(10):688-703.