Correlation between qualitative and semi-quantitative ultrasound assessment of diffuse fatty liver disease: A case-control study

Abstract

Objective: To study the relationship between qualitative and semi-quantitative assessment of diffuse liver steatosis in ultrasound. Patients and Methods: This was a case-control study, conducted in the Campus University Hospital Centre of Lome (Togo) over a 3-month period. It included 40 patients showing ultrasonographic signs of diffuse hepatic steatosis and 40 volunteers (healthy) whose echostructure and echogenicity of the hepatic parenchyma were normal. The B-mode sonographic grade of steatosis was compared with the hepatorenal echogenicity gradient and the ultrasound attenuation coefficient. Results: The average body mass index in patients was 30.87 ± 4.65 kg/m2 versus 24.25 ± 4.30 kg/m2 in the healthy group (p < 0.00001). Hepatomegaly was observed in 57.5% of the patients versus 17.5% in the healthy group (p = 0.0005). The average hepatorenal echogenicity ratio was 1.18 ± 0.07 in patients versus 1.01 ± 0.03 in the healthy group (p < 0.00001). The average difference in hepatorenal echogenicity was 9.30 ± 3.41 dB in patients versus 1.52 ± 1.07 dB in the healthy group (p < 0.00001). The attenuation of ultrasound waves increased with the grade of steatosis, averaging 0.08 ± 0.23 dB/cm/MHz (ranging from −0.33 to 0.61 dB/cm/MHz) in patients versus −0.24 ± 0.21 (ranging from −0.69 to 0.19 dB/cm/MHz) in the healthy group (p < 0.00001). Conclusion: Despite the advancements in new ultrasound technologies today, qualitative methods continue to be effective for the detection of hepatic steatosis and could prove useful in monitoring the effectiveness of hepatic steatosis treatment.