Diagnosis of hepatic steatosis by contrast-enhanced abdominal computed tomography

Radiologia Brasileira

Rodrigo Da Fonseca Monjardim¹  Danilo Manuel Cerqueira Costa¹  Ricardo Francisco Tavares Romano¹  Priscila Silveira Salvadori¹  Jaime De Vargas Conde Dos Santos¹  Augusto Castelli Von Atzingen¹  David Carlos Shigueoka¹  Giuseppe D'ippolito¹ 

关键词: Fatty liver;    Steatosis;    Liver disease;    Tomography;    Multidetector computed tomography;    Contrast media;    Fígado gorduroso;    Esteatose hepática;    Hepatopatias;    Tomografia;    Tomografia computadorizada multidetectores;    Meios de contraste;   

DOI  :  10.1590/S0100-39842013000300005

来源: SciELO

【 摘 要 】

Objective To evaluate the diagnostic capacity of abdominal computed tomography in the assessment of hepatic steatosis using the portal phase with a simplified calculation method as compared with the non-contrast-enhanced phase. Materials and Methods In the present study, 150 patients were retrospectively evaluated by means of non-contrast-enhanced and contrast-enhanced computed tomography. One hundred patients had hepatic steatosis and 50 were control subjects. For the diagnosis of hepatic steatosis in the portal phase, the authors considered a result of < 104 HU calculated by the formula [L - 0.3 × (0.75 × P + 0.25 × A)] / 0.7, where L, P and A represent the attenuation of the liver, of the main portal vein and abdominal aorta, respectively. Sensitivity, specificity, positive and negative predictive values were calculated, using non-contrast-enhanced computed tomography as the reference standard. Results The simplified calculation method with portal phase for the diagnosis of hepatic steatosis showed 100% sensitivity, 36% specificity, negative predictive value of 100% and positive predictive value of 75.8%. The rate of false positive results was 64%. False negative results were not observed. Conclusion The portal phase presents an excellent sensitivity in the diagnosis of hepatic steatosis, as compared with the non-contrast-enhanced phase of abdominal computed tomography. However, the method has low specificity.

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