Evaluation of Hepatic Steatosis with CT and Correlation with Anthropometric Measurements

Author(s): Onur Taydas*, Ural Koc

Journal Name: Current Medical Imaging
Formerly: Current Medical Imaging Reviews

Volume 16 , Issue 4 , 2020

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Graphical Abstract:


Abstract:

Objective: The aim of the study was to evaluate hepatic steatosis in an asymptomatic group of patients with unenhanced abdominal computed tomography (CT) and to compare the results with anthropometric measurements.

Methods: The study included 617 patients aged 18-93 years, who underwent unenhanced abdominopelvic CT between January 2016 and December 2017. Three imaging criteria were used in the assessment of hepatic steatosis on CT: mean region of interest (ROI) value of measured liver lobe (40 HU ≥), mean ROI value of measured liver lobe / measured spleen mean ROI value (1 ≥), mean ROI value of measured liver lobe - mean ROI value of spleen (10 HU≥). The liver fat was quantitatively assessed both visually and using multidetector CT grading. The anthropometric measurements used were the size of the liver and spleen, abdominal anterior-posterior diameter, abdominal transverse diameter, abdominal circumference, subcutaneous adipose tissue area, and anterior, posterior, and posterolateral subcutaneous adipose tissue thickness.

Results: The prevalence of hepatic steatosis was 29.3% according to the visual evaluation, 29.8% according to the quantitative evaluation, 67.1% according to at least one criterion and 23.3% according to at least two criteria. A positive correlation was determined between hepatic steatosis and anthropometric measurements. Differences between the genders were observed in both hepatic steatosis and anthropometric measurements.

Conclusion: By setting more objective criteria for evaluation, with the possibility of quantitative analysis in particular, non-contrast CT will have a more important role in assessing liver fat in the future.

Keywords: Hepatic steatosis, computed tomography, anthropometric measurements, quantitative analysis, prevalence, grading.

[1]
Fabbrini E, Sullivan S, Klein S. Obesity and nonalcoholic fatty liver disease: biochemical, metabolic, and clinical implications. Hepatology 2010; 51(2): 679-89.
[http://dx.doi.org/10.1002/hep.23280] [PMID: 20041406]
[2]
Ludwig J, Viggiano TR, McGill DB, Oh BJ. Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease. Mayo Clin Proc 1980; 55(7): 434-8.
[PMID: 7382552]
[3]
Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther 2011; 34(3): 274-85.
[http://dx.doi.org/10.1111/j.1365-2036.2011.04724.x] [PMID: 21623852]
[4]
Farrell GC, Larter CZ. Nonalcoholic fatty liver disease: from steatosis to cirrhosis. Hepatology 2006; 43(2)(Suppl. 1): S99-S112.
[http://dx.doi.org/10.1002/hep.20973] [PMID: 16447287]
[5]
Korenblat KM, Fabbrini E, Mohammed BS, Klein S. Liver, muscle, and adipose tissue insulin action is directly related to intrahepatic triglyceride content in obese subjects. Gastroenterology 2008; 134(5): 1369-75.
[http://dx.doi.org/10.1053/j.gastro.2008.01.075] [PMID: 18355813]
[6]
Ratziu V, Charlotte F, Heurtier A, et al. LIDO Study Group. Sampling variability of liver biopsy in nonalcoholic fatty liver disease. Gastroenterology 2005; 128(7): 1898-906.
[http://dx.doi.org/10.1053/j.gastro.2005.03.084] [PMID: 15940625]
[7]
Lee SS, Park SH. Radiologic evaluation of nonalcoholic fatty liver disease. World J Gastroenterol 2014; 20(23): 7392-402.
[http://dx.doi.org/10.3748/wjg.v20.i23.7392] [PMID: 24966609]
[8]
Saba L, di Martino M, Bosco S, et al. MDCT classification of steatotic liver: a multicentric analysis. Eur J Gastroenterol Hepatol 2015; 27(3): 290-7.
[http://dx.doi.org/10.1097/MEG.0000000000000277] [PMID: 25629573]
[9]
McCullough AJ. Update on nonalcoholic fatty liver disease. J Clin Gastroenterol 2002; 34(3): 255-62.
[http://dx.doi.org/10.1097/00004836-200203000-00013] [PMID: 11873108]
[10]
Sonsuz A, Baysal B. Karaciğer Yağlanması ve Nonalkolik Steatohepatit. Güncel Gastroenteroloji 2011; 15: 98-106.
[11]
Kasapoglu B, Turkay C, Yalcin KS, Carlioglu A, Sozen M, Koktener A. Low vitamin D levels are associated with increased risk for fatty liver disease among non-obese adults. Clin Med (Lond) 2013; 13(6): 576-9.
[http://dx.doi.org/10.7861/clinmedicine.13-6-576] [PMID: 24298105]
[12]
Wells MM, Li Z, Addeman B, et al. Computed tomography measurement of hepatic steatosis: Prevalence of hepatic steatosis in a Canadian population. Can J Gastroenterol Hepatol 2016; 20164930987
[http://dx.doi.org/10.1155/2016/4930987] [PMID: 27446844]
[13]
Boyce CJ, Pickhardt PJ, Kim DH, et al. Hepatic steatosis (fatty liver disease) in asymptomatic adults identified by unenhanced low-dose CT. AJR Am J Roentgenol 2010; 194(3): 623-8.
[http://dx.doi.org/10.2214/AJR.09.2590] [PMID: 20173137]
[14]
Zhang YN, Fowler KJ, Hamilton G, et al. Liver fat imaging-a clinical overview of ultrasound, CT, and MR imaging. Br J Radiol 2018; 91(1089) 20170959
[http://dx.doi.org/10.1259/bjr.20170959] [PMID: 29722568]
[15]
Bohte AE, van Werven JR, Bipat S, Stoker J. The diagnostic accuracy of US, CT, MRI and 1H-MRS for the evaluation of hepatic steatosis compared with liver biopsy: a meta-analysis. Eur Radiol 2011; 21(1): 87-97.
[http://dx.doi.org/10.1007/s00330-010-1905-5] [PMID: 20680289]
[16]
van Werven JR, Marsman HA, Nederveen AJ, et al. Assessment of hepatic steatosis in patients undergoing liver resection: comparison of US, CT, T1-weighted dual-echo MR imaging, and point-resolved 1H MR spectroscopy. Radiology 2010; 256(1): 159-68.
[http://dx.doi.org/10.1148/radiol.10091790] [PMID: 20574093]
[17]
Rodger F, Roditi G, Aboumarzouk OM. Diagnostic Accuracy of low and ultra-low dose ct for identification of urinary tract stones: A systematic review. Urol Int 2018; 100(4): 375-85.
[http://dx.doi.org/10.1159/000488062] [PMID: 29649823]
[18]
Gervaise A, Gervaise-Henry C, Pernin M, Naulet P, Junca-Laplace C, Lapierre-Combes M. How to perform low-dose computed tomography for renal colic in clinical practice. Diagn Interv Imaging 2016; 97(4): 393-400.
[http://dx.doi.org/10.1016/j.diii.2015.05.013] [PMID: 26522944]
[19]
Kramer H, Pickhardt PJ, Kliewer MA, et al. Accuracy of liver fat quantification with advanced CT, MRI, and ultrasound techniques: Prospective comparison with MR spectroscopy. AJR Am J Roentgenol 2017; 208(1): 92-100.
[http://dx.doi.org/10.2214/AJR.16.16565] [PMID: 27726414]
[20]
Geraghty EM, Boone JM. Determination of height, weight, body mass index, and body surface area with a single abdominal CT image. Radiology 2003; 228(3): 857-63.
[http://dx.doi.org/10.1148/radiol.2283020095] [PMID: 12881576]
[21]
Gaba RC, Knuttinen MG, Brodsky TR, et al. Hepatic steatosis: correlations of body mass index, CT fat measurements, and liver density with biopsy results. Diagn Interv Radiol 2012; 18(3): 282-7.
[PMID: 22258794]
[22]
Eisner BH, Zargooshi J, Berger AD, et al. Gender differences in subcutaneous and perirenal fat distribution. Surg Radiol Anat 2010; 32(9): 879-82.
[http://dx.doi.org/10.1007/s00276-010-0692-7] [PMID: 20607260]
[23]
Jang S, Lee CH, Choi KM, et al. Correlation of fatty liver and abdominal fat distribution using a simple fat computed tomography protocol. World J Gastroenterol 2011; 17(28): 3335-41.
[http://dx.doi.org/10.3748/wjg.v17.i28.3335] [PMID: 21876622]
[24]
Gasim GI, Elshehri FM, Kheidr M, Alshubaily FK, ElZaki EM, Musa IR. The use of computed tomography in the diagnosis of fatty liver and abdominal fat distribution among a Saudi population. Open Access Maced J Med Sci 2017; 5(6): 762-5.
[http://dx.doi.org/10.3889/oamjms.2017.187] [PMID: 29104685]
[25]
Mercuro G, Deidda M, Piras A, Dessalvi CC, Maffei S, Rosano GM. Gender determinants of cardiovascular risk factors and diseases. J Cardiovasc Med (Hagerstown) 2010; 11(3): 207-20.
[http://dx.doi.org/10.2459/JCM.0b013e32833178ed] [PMID: 19829128]
[26]
Rennenberg RJ, Kessels AG, Schurgers LJ, van Engelshoven JM, de Leeuw PW, Kroon AA. Vascular calcifications as a marker of increased cardiovascular risk: a meta-analysis. Vasc Health Risk Manag 2009; 5(1): 185-97.
[http://dx.doi.org/10.2147/VHRM.S4822] [PMID: 19436645]


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Article Details

VOLUME: 16
ISSUE: 4
Year: 2020
Page: [452 - 458]
Pages: 7
DOI: 10.2174/1573405614666181029115243
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