Background: The diagnosis of hepatic steatosis has been well-described on unenhanced computed tomography (UECT) study. However, current UECT often discarded from the abdominal CT protocol due to radiation dose reduction. Objective: To determine accuracy of contrast-enhanced CT (CECT) for diagnosis of hepatic steatosis. Methods: A total of 1,001 patients who underwent unenhanced and portal venous phase abdominal CT studies were assessed by using region-of-interests of liver and spleen, and visual detection of focal fat sparing. UECT diagnostic criteria were used as the standard reference. Results: The optimal cut-offs on CECT images were 110 Hounsfield unit (HU) of liver attenuation and -20 HU of liver-splenic differential (L-S) attenuation. Sensitivity, specificity, accuracy and receiver operating characteristic curve areas for quantitative liver attenuation values were 90.4%, 73.6%, 75.9% and 0.926, respectively; and for L-S attenuation values were 83.1%, 70.8%, 72.5% and 0.856, respectively. Qualitatively, geographic fat sparing was 100.0% specificity; however, its sensitivity (50.7%) was rather low. Conclusion: Portal venous phase CECT can be used for detection of hepatic steatosis in abdominal CECT study without the preceding unenhanced phase.
Faculty of Medicine, Chulalongkorn University
Tangsiwong, Thipsumon and Chulroek, Thitinan
"Usefulness of contrast-enhanced computed tomography for diagnosing hepatic steatosis,"
Chulalongkorn Medical Journal: Vol. 65:
4, Article 15.
Available at: https://digital.car.chula.ac.th/clmjournal/vol65/iss4/15