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Accuracy of Ultrasonography and Different CT Techniques in Diagnosis and Grading of Hepatic Steatosis in Chronic Hepatitis C Virus Patients

Received: 27 August 2014    Accepted: 12 September 2014    Published: 30 September 2014
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Abstract

Objective: This study aims to assess the diagnostic utility of ultrasonography and which methods of measuring attenuation on computed tomography scans is best for detection and grading of hepatic fat content in patients with chronic hepatitis C virus (HCV) infection. Materials and Methods: This study included 65 patients, withchronic hepatitis C virus infection, who had liver biopsies as a part of pre-requirement for interferon therapy. All patients submitted to ultrasound; non enhanced and enhanced CT. Attenuation measurements were obtained from 3 regions of interest in the liver and three in the spleen on both unenhanced and portal phase contrast-enhanced CT images. Hepatic attenuation measurements were analyzed both with and without normalization with the spleen. Normalization included both differences and ratios between hepatic and splenic attenuation values. Average attenuation values of the liver were compared with pathologic fat content, as were the differences and ratios between hepatic and splenic attenuation values. Results: Ultrasound had a sensitivity of 76% and specificity 73.3% in the diagnosis of hepatic steatosis. Also ultrasound accurately graded 41 out of the 65 (63.1%) patients included in the study. The simple measurement of hepatic attenuation on non enhanced CT (CTL) had the best parameters for diagnosis of hepatic steatosis with sensitivity 83%, specificity 93.3% and positive predictive value (PPV) 97.6%. All series of R2 values for the unenhanced CT scans were higher than those for the contrast-enhanced images. The R2 values for simple liver attenuation measurement without comparison with splenic attenuation were higher than the values in which splenic measurements were considered. Conclusion: Ultrasound and non enhanced CT can be used as screening tools for detection of hepatic steatosis in patients with chronic hepatitis C virus patients. Simple measurement of hepatic attenuation on unenhanced CT is more accurate than differential liver spleen values. Also, unenhanced CT can differentiate between mild-moderate and severe steatosis.

Published in International Journal of Medical Imaging (Volume 2, Issue 5)
DOI 10.11648/j.ijmi.20140205.14
Page(s) 112-118
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Hepatic Steatosis, CT, Ultrasound, Hepatitis C Viral Infection

References
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    Manal Ezzat Badawy, Mohamed Fouad Sherif, Elsayed Tharwa. (2014). Accuracy of Ultrasonography and Different CT Techniques in Diagnosis and Grading of Hepatic Steatosis in Chronic Hepatitis C Virus Patients. International Journal of Medical Imaging, 2(5), 112-118. https://doi.org/10.11648/j.ijmi.20140205.14

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    ACS Style

    Manal Ezzat Badawy; Mohamed Fouad Sherif; Elsayed Tharwa. Accuracy of Ultrasonography and Different CT Techniques in Diagnosis and Grading of Hepatic Steatosis in Chronic Hepatitis C Virus Patients. Int. J. Med. Imaging 2014, 2(5), 112-118. doi: 10.11648/j.ijmi.20140205.14

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    AMA Style

    Manal Ezzat Badawy, Mohamed Fouad Sherif, Elsayed Tharwa. Accuracy of Ultrasonography and Different CT Techniques in Diagnosis and Grading of Hepatic Steatosis in Chronic Hepatitis C Virus Patients. Int J Med Imaging. 2014;2(5):112-118. doi: 10.11648/j.ijmi.20140205.14

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  • @article{10.11648/j.ijmi.20140205.14,
      author = {Manal Ezzat Badawy and Mohamed Fouad Sherif and Elsayed Tharwa},
      title = {Accuracy of Ultrasonography and Different CT Techniques in Diagnosis and Grading of Hepatic Steatosis in Chronic Hepatitis C Virus Patients},
      journal = {International Journal of Medical Imaging},
      volume = {2},
      number = {5},
      pages = {112-118},
      doi = {10.11648/j.ijmi.20140205.14},
      url = {https://doi.org/10.11648/j.ijmi.20140205.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20140205.14},
      abstract = {Objective: This study aims to assess the diagnostic utility of ultrasonography and which methods of measuring attenuation on computed tomography scans is best for detection and grading of hepatic fat content in patients with chronic hepatitis C virus (HCV) infection. Materials and Methods: This study included 65 patients, withchronic hepatitis C virus infection, who had liver biopsies as a part of pre-requirement for interferon therapy. All patients submitted to ultrasound; non enhanced and enhanced CT. Attenuation measurements were obtained from 3 regions of interest in the liver and three in the spleen on both unenhanced and portal phase contrast-enhanced CT images. Hepatic attenuation measurements were analyzed both with and without normalization with the spleen. Normalization included both differences and ratios between hepatic and splenic attenuation values. Average attenuation values of the liver were compared with pathologic fat content, as were the differences and ratios between hepatic and splenic attenuation values. Results: Ultrasound had a sensitivity of 76% and specificity 73.3% in the diagnosis of hepatic steatosis. Also ultrasound accurately graded 41 out of the 65 (63.1%) patients included in the study. The simple measurement of hepatic attenuation on non enhanced CT (CTL) had the best parameters for diagnosis of hepatic steatosis with sensitivity 83%, specificity 93.3% and positive predictive value (PPV) 97.6%. All series of R2 values for the unenhanced CT scans were higher than those for the contrast-enhanced images. The R2 values for simple liver attenuation measurement without comparison with splenic attenuation were higher than the values in which splenic measurements were considered. Conclusion: Ultrasound and non enhanced CT can be used as screening tools for detection of hepatic steatosis in patients with chronic hepatitis C virus patients. Simple measurement of hepatic attenuation on unenhanced CT is more accurate than differential liver spleen values. Also, unenhanced CT can differentiate between mild-moderate and severe steatosis.},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - Accuracy of Ultrasonography and Different CT Techniques in Diagnosis and Grading of Hepatic Steatosis in Chronic Hepatitis C Virus Patients
    AU  - Manal Ezzat Badawy
    AU  - Mohamed Fouad Sherif
    AU  - Elsayed Tharwa
    Y1  - 2014/09/30
    PY  - 2014
    N1  - https://doi.org/10.11648/j.ijmi.20140205.14
    DO  - 10.11648/j.ijmi.20140205.14
    T2  - International Journal of Medical Imaging
    JF  - International Journal of Medical Imaging
    JO  - International Journal of Medical Imaging
    SP  - 112
    EP  - 118
    PB  - Science Publishing Group
    SN  - 2330-832X
    UR  - https://doi.org/10.11648/j.ijmi.20140205.14
    AB  - Objective: This study aims to assess the diagnostic utility of ultrasonography and which methods of measuring attenuation on computed tomography scans is best for detection and grading of hepatic fat content in patients with chronic hepatitis C virus (HCV) infection. Materials and Methods: This study included 65 patients, withchronic hepatitis C virus infection, who had liver biopsies as a part of pre-requirement for interferon therapy. All patients submitted to ultrasound; non enhanced and enhanced CT. Attenuation measurements were obtained from 3 regions of interest in the liver and three in the spleen on both unenhanced and portal phase contrast-enhanced CT images. Hepatic attenuation measurements were analyzed both with and without normalization with the spleen. Normalization included both differences and ratios between hepatic and splenic attenuation values. Average attenuation values of the liver were compared with pathologic fat content, as were the differences and ratios between hepatic and splenic attenuation values. Results: Ultrasound had a sensitivity of 76% and specificity 73.3% in the diagnosis of hepatic steatosis. Also ultrasound accurately graded 41 out of the 65 (63.1%) patients included in the study. The simple measurement of hepatic attenuation on non enhanced CT (CTL) had the best parameters for diagnosis of hepatic steatosis with sensitivity 83%, specificity 93.3% and positive predictive value (PPV) 97.6%. All series of R2 values for the unenhanced CT scans were higher than those for the contrast-enhanced images. The R2 values for simple liver attenuation measurement without comparison with splenic attenuation were higher than the values in which splenic measurements were considered. Conclusion: Ultrasound and non enhanced CT can be used as screening tools for detection of hepatic steatosis in patients with chronic hepatitis C virus patients. Simple measurement of hepatic attenuation on unenhanced CT is more accurate than differential liver spleen values. Also, unenhanced CT can differentiate between mild-moderate and severe steatosis.
    VL  - 2
    IS  - 5
    ER  - 

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Author Information
  • Radiology department, Tanta University, Egypt

  • Radiology department, Tanta University, Egypt

  • Hepatology department, Menofyia University, Egypt

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