Specificity of unenhanced CT for non-invasive diagnosis of hepatic steatosis: implications for the investigation of the natural history of incidental steatosis.
Objectives: To determine a highly specific liver attenuation threshold at unenhanced CT for biopsy-proven moderate to severe hepatic steatosis (≥30% at histology).Methods: 315 asymptomatic adults (mean age ± SD, 31.5 ± 10.1 years; 207 men, 108 women) underwent same-day unenhanced liver CT and ultras...
| Publicado en: | European Radiology Vol. 22; no. 5; pp. 1075 - 1083 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
May2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104352576&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104352576 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: May2012 vid: 22 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104352576 NLM22138733 2011511543 10.1007/s00330-011-2349-2 NLM22138733 104352576 ppf: 1075 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Specificity of unenhanced CT for non-invasive diagnosis of hepatic steatosis: implications for the investigation of the natural history of incidental steatosis. aug: au: Pickhardt PJ Park SH Hahn L Lee SG Bae KT Yu ES Pickhardt, Perry J Park, Seong Ho Hahn, Luke Lee, Sung-Gyu Bae, Kyongtae T Yu, Eun Sil affil: Department of Radiology, University of Wisconsin School of Medicine & Public Health, E3/311 Clinical Science Center, 600 Highland Ave., Madison, WI 53792-3252, USA sug: subj: Fatty Liver Epidemiology Fatty Liver Radiography Tomography, X-Ray Computed Statistics and Numerical Data Adult Contrast Media Fatty Liver Pathology Female Human Diagnosis Male Prevalence Reproducibility of Results South Korea Sensitivity and Specificity Single-Blind Studies Adult: 19-44 years Female Male ab: Objectives: To determine a highly specific liver attenuation threshold at unenhanced CT for biopsy-proven moderate to severe hepatic steatosis (≥30% at histology).Methods: 315 asymptomatic adults (mean age ± SD, 31.5 ± 10.1 years; 207 men, 108 women) underwent same-day unenhanced liver CT and ultrasound-guided liver biopsy. Blinded to biopsy results, CT liver attenuation was measured using standard region-of-interest methodology. Multiple linear regression analysis was used to assess the relationship of CT liver attenuation with patient age, gender, BMI, CT system, and hepatic fat and iron content.Results: Thirty-nine subjects had moderate to severe steatosis and 276 had mild or no steatosis. A liver attenuation threshold of 48 HU was 100% specific (276/276) for moderate to severe steatosis, with no false-positives. Sensitivity, PPV and NPV at this HU threshold was 53.8%, 100% and 93.9%. Hepatic fat content was the overwhelming determinant of liver attenuation values, but CT system (P < 0.001), and hepatic iron (P = 0.035) also had a statistically significant independent association.Conclusions: Unenhanced CT liver attenuation alone is highly specific for moderate to severe hepatic steatosis, allowing for confident non-invasive identification of large retrospective/prospective cohorts for natural history evaluation of incidental non-alcoholic fatty liver disease. Low sensitivity, however, precludes effective population screening at this threshold.Key Points: • Unenhanced CT liver attenuation is highly specific for diagnosing moderate/severe hepatic steatosis. • Unenhanced CT can identify large cohorts for epidemiological studies of incidental steatosis. • Unenhanced CT is not, however, effective for population screening for hepatic steatosis. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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