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Contrast-enhanced computed tomography for the diagnosis of fatty liver: prospective study with same-day biopsy used as the reference standard

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Abstract

Purpose: The study purpose was to prospectively determine the accuracy of contrast-enhanced CT in diagnosing fatty liver using same-day biopsy as the reference standard. Materials and methods: One hundred seventy-nine potential living liver donors underwent unenhanced and portal-phase contrast-enhanced hepatic CT and subsequent liver biopsy on the same day. Attenuation difference between the liver and the spleen on unenhanced ( pre L-S) and contrast-enhanced ( post L-S) images and blood-subtracted hepatic attenuation on contrast-enhanced images ( post L-B), calculated by [L - 0.3 × (0.75 × P + 0.25 × A)]/0.7 where L, P and A represent the attenuation of the liver, main portal vein and abdominal aorta, respectively, were obtained. The accuracy of these indices in diagnosing fatty liver according to various threshold levels, 5%-30% histological steatosis in increments of 5%, was compared using ROC analysis. Results: The area under the ROC curve for pre L-S, post L-S and post L-B was 0.663–0.918, 0.712–0.847 and 0.821–0.923, respectively, depending on the threshold levels of hepatic steatosis. The accuracy of pre L-S and post L-S did not differ (P ≥ 0.054), despite a trend towards a lower accuracy with post L-S. post L-B yielded higher accuracy than pre L-S at threshold levels of 5% and 10% (P ≤ 0.002) and similar accuracy to pre L-S at the other threshold levels (P ≥ 0.144). Conclusion: Portal-phase contrast-enhanced CT has a similar, or even greater, accuracy than unenhanced CT in diagnosing fatty liver.

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388–1 Poongnap-2dong, Songpa-gu, Seoul, 138–736, Korea

    Dae Yoon Kim, Seong Ho Park, Seung Soo Lee, Hye Jin Kim, So Yeon Kim, Min-Young Kim & Yedaun Lee

  2. Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 388–1 Poongnap-2dong, Songpa-gu, Seoul, 138–736, Korea

    Sung-Gyu Lee

  3. Department of Diagnostic Pathology, University of Ulsan College of Medicine, Asan Medical Center, 388–1 Poongnap-2dong, Songpa-gu, Seoul, 138–736, Korea

    Eun Sil Yu

  4. Department of Medical Imaging, University Health Network, University of Toronto, Toronto, ON, Canada

    Tae Kyoung Kim & Korosh Khalili

  5. University of Ulsan College of Medicine, 388–1 Poongnap-2dong, Songpa-gu, Seoul, 138–736, Korea

    Mi Hyun Bae & Joo Yeon Lee

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  1. Dae Yoon Kim
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  2. Seong Ho Park
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Correspondence to Seong Ho Park.

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Financial support:

This study was supported by a grant (07–428) from the Asan Institute for Life Sciences, Seoul, Korea

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Kim, D.Y., Park, S.H., Lee, S.S. et al. Contrast-enhanced computed tomography for the diagnosis of fatty liver: prospective study with same-day biopsy used as the reference standard. Eur Radiol 20, 359–366 (2010). https://doi.org/10.1007/s00330-009-1560-x

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  • DOI: https://doi.org/10.1007/s00330-009-1560-x

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