Diagnostic criteria for fatty infiltration of the liver on contrast- enhanced helical CT
The purpose of the study was to develop quantitative and qualitative criteria for diagnosing fatty liver on contrast-enhanced helical CT. Differential liver-spleen attenuation was evaluated between 80 and 120 sec after injection in 76 patients who underwent contrast-enhanced helical CT. Unenhanced C...
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| Veröffentlicht in: | American journal of roentgenology (1976) 1998-09, Vol.171 (3), p.659-664 |
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| container_title | American journal of roentgenology (1976) |
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| creator | Jacobs, JE Birnbaum, BA Shapiro, MA Langlotz, CP Slosman, F Rubesin, SE Horii, SC |
| description | The purpose of the study was to develop quantitative and qualitative criteria for diagnosing fatty liver on contrast-enhanced helical CT.
Differential liver-spleen attenuation was evaluated between 80 and 120 sec after injection in 76 patients who underwent contrast-enhanced helical CT. Unenhanced CT images had earlier established fatty liver when the liver minus spleen attenuation difference was less than or equal to -10 H (n = 18). Four observers who had not seen the unenhanced images used contrast-enhanced CT images to assess the presence of fatty liver on a five-point Likert scale, the presence of geographic areas spared from fatty infiltration, and the relative liver-spleen attenuation. The diagnostic accuracies of various imaging criteria were compared using McNemar's chi-square test (for sensitivity and specificity) and analysis of receiver operating characteristic curves.
Sensitivity, specificity, and receiver operating characteristic curve areas for observers' qualitative judgments were 54%, 95%, and .91, respectively; for quantitative differential liver-spleen attenuation (80-100 sec; -20.5 H discriminatory value), the values were 86%, 87%, and .94, respectively; and for quantitative differential liver-spleen attenuation (101-120 sec; -18.5 H discriminatory value), the values were 93%, 93%, and .98, respectively. Differential liver-spleen attenuation was time-dependent; overlap was noted between healthy subjects and patients with fatty liver. Qualitatively, geographic sparing was highly specific (94%) for fatty liver, whereas liver attenuation greater than or equal to spleen attenuation excluded fatty liver in all but one case.
Although quantitative and qualitative criteria for diagnosing fatty liver on helical CT can be determined, they are protocol-specific. Limited unenhanced hepatic CT remains the optimal technique for detection of fatty infiltration of the liver. |
| doi_str_mv | 10.2214/ajr.171.3.9725292 |
| format | Article |
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Differential liver-spleen attenuation was evaluated between 80 and 120 sec after injection in 76 patients who underwent contrast-enhanced helical CT. Unenhanced CT images had earlier established fatty liver when the liver minus spleen attenuation difference was less than or equal to -10 H (n = 18). Four observers who had not seen the unenhanced images used contrast-enhanced CT images to assess the presence of fatty liver on a five-point Likert scale, the presence of geographic areas spared from fatty infiltration, and the relative liver-spleen attenuation. The diagnostic accuracies of various imaging criteria were compared using McNemar's chi-square test (for sensitivity and specificity) and analysis of receiver operating characteristic curves.
Sensitivity, specificity, and receiver operating characteristic curve areas for observers' qualitative judgments were 54%, 95%, and .91, respectively; for quantitative differential liver-spleen attenuation (80-100 sec; -20.5 H discriminatory value), the values were 86%, 87%, and .94, respectively; and for quantitative differential liver-spleen attenuation (101-120 sec; -18.5 H discriminatory value), the values were 93%, 93%, and .98, respectively. Differential liver-spleen attenuation was time-dependent; overlap was noted between healthy subjects and patients with fatty liver. Qualitatively, geographic sparing was highly specific (94%) for fatty liver, whereas liver attenuation greater than or equal to spleen attenuation excluded fatty liver in all but one case.
Although quantitative and qualitative criteria for diagnosing fatty liver on helical CT can be determined, they are protocol-specific. Limited unenhanced hepatic CT remains the optimal technique for detection of fatty infiltration of the liver.</description><identifier>ISSN: 0361-803X</identifier><identifier>EISSN: 1546-3141</identifier><identifier>DOI: 10.2214/ajr.171.3.9725292</identifier><identifier>PMID: 9725292</identifier><identifier>CODEN: AAJRDX</identifier><language>eng</language><publisher>Leesburg, VA: Am Roentgen Ray Soc</publisher><subject>Biological and medical sciences ; Contrast Media ; Digestive system ; Fatty Liver - diagnostic imaging ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Image Processing, Computer-Assisted ; Investigative techniques, diagnostic techniques (general aspects) ; Iothalamate Meglumine ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Male ; Medical sciences ; Middle Aged ; Other diseases. Semiology ; Prospective Studies ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed - methods</subject><ispartof>American journal of roentgenology (1976), 1998-09, Vol.171 (3), p.659-664</ispartof><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c422t-403e689019aaa9996339f9c97e05f4cb22a2d18014e4020956d3686692e1b6f63</citedby><cites>FETCH-LOGICAL-c422t-403e689019aaa9996339f9c97e05f4cb22a2d18014e4020956d3686692e1b6f63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4106,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2372069$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9725292$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jacobs, JE</creatorcontrib><creatorcontrib>Birnbaum, BA</creatorcontrib><creatorcontrib>Shapiro, MA</creatorcontrib><creatorcontrib>Langlotz, CP</creatorcontrib><creatorcontrib>Slosman, F</creatorcontrib><creatorcontrib>Rubesin, SE</creatorcontrib><creatorcontrib>Horii, SC</creatorcontrib><title>Diagnostic criteria for fatty infiltration of the liver on contrast- enhanced helical CT</title><title>American journal of roentgenology (1976)</title><addtitle>AJR Am J Roentgenol</addtitle><description>The purpose of the study was to develop quantitative and qualitative criteria for diagnosing fatty liver on contrast-enhanced helical CT.
Differential liver-spleen attenuation was evaluated between 80 and 120 sec after injection in 76 patients who underwent contrast-enhanced helical CT. Unenhanced CT images had earlier established fatty liver when the liver minus spleen attenuation difference was less than or equal to -10 H (n = 18). Four observers who had not seen the unenhanced images used contrast-enhanced CT images to assess the presence of fatty liver on a five-point Likert scale, the presence of geographic areas spared from fatty infiltration, and the relative liver-spleen attenuation. The diagnostic accuracies of various imaging criteria were compared using McNemar's chi-square test (for sensitivity and specificity) and analysis of receiver operating characteristic curves.
Sensitivity, specificity, and receiver operating characteristic curve areas for observers' qualitative judgments were 54%, 95%, and .91, respectively; for quantitative differential liver-spleen attenuation (80-100 sec; -20.5 H discriminatory value), the values were 86%, 87%, and .94, respectively; and for quantitative differential liver-spleen attenuation (101-120 sec; -18.5 H discriminatory value), the values were 93%, 93%, and .98, respectively. Differential liver-spleen attenuation was time-dependent; overlap was noted between healthy subjects and patients with fatty liver. Qualitatively, geographic sparing was highly specific (94%) for fatty liver, whereas liver attenuation greater than or equal to spleen attenuation excluded fatty liver in all but one case.
Although quantitative and qualitative criteria for diagnosing fatty liver on helical CT can be determined, they are protocol-specific. Limited unenhanced hepatic CT remains the optimal technique for detection of fatty infiltration of the liver.</description><subject>Biological and medical sciences</subject><subject>Contrast Media</subject><subject>Digestive system</subject><subject>Fatty Liver - diagnostic imaging</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Image Processing, Computer-Assisted</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Iothalamate Meglumine</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Other diseases. Semiology</subject><subject>Prospective Studies</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>Tomography, X-Ray Computed - methods</subject><issn>0361-803X</issn><issn>1546-3141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkE1LAzEQhoMotVZ_gAchB_G2NR-7yeYo9RMELxV6C2k66UbSXU1Si__eLV30NAzvO-_MPAhdUjJljJa35iNOqaRTPlWSVUyxIzSmVSkKTkt6jMaEC1rUhC9O0VlKH4QQWSs5QqPBPkaLe2_WbZeyt9hGnyF6g10XsTM5_2DfOh9yNNl3Le4czg3g4L8h4r63XdtLKRcY2sa0Fla4geCtCXg2P0cnzoQEF0OdoPfHh_nsuXh9e3qZ3b0WtmQsFyXhIGpFqDLGKKUE58opqySQypV2yZhhK1oTWkJJGFGVWHFRC6EY0KVwgk_QzSH3M3ZfW0hZb3yyEIJpodsmLXktZC33Rnow2tilFMHpz-g3Jv5oSvSepu5p6p6m5nrA089cDeHb5QZWfxP_-vWgm9S_7WJPwac_G-OSEaH-b2z8utn5CDptTAh9KNW73e6wU1SK_wLM_omt</recordid><startdate>19980901</startdate><enddate>19980901</enddate><creator>Jacobs, JE</creator><creator>Birnbaum, BA</creator><creator>Shapiro, MA</creator><creator>Langlotz, CP</creator><creator>Slosman, F</creator><creator>Rubesin, SE</creator><creator>Horii, SC</creator><general>Am Roentgen Ray Soc</general><general>American Roentgen Ray Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19980901</creationdate><title>Diagnostic criteria for fatty infiltration of the liver on contrast- enhanced helical CT</title><author>Jacobs, JE ; Birnbaum, BA ; Shapiro, MA ; Langlotz, CP ; Slosman, F ; Rubesin, SE ; Horii, SC</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c422t-403e689019aaa9996339f9c97e05f4cb22a2d18014e4020956d3686692e1b6f63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Biological and medical sciences</topic><topic>Contrast Media</topic><topic>Digestive system</topic><topic>Fatty Liver - diagnostic imaging</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Image Processing, Computer-Assisted</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Iothalamate Meglumine</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Other diseases. Semiology</topic><topic>Prospective Studies</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><topic>Tomography, X-Ray Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jacobs, JE</creatorcontrib><creatorcontrib>Birnbaum, BA</creatorcontrib><creatorcontrib>Shapiro, MA</creatorcontrib><creatorcontrib>Langlotz, CP</creatorcontrib><creatorcontrib>Slosman, F</creatorcontrib><creatorcontrib>Rubesin, SE</creatorcontrib><creatorcontrib>Horii, SC</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of roentgenology (1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jacobs, JE</au><au>Birnbaum, BA</au><au>Shapiro, MA</au><au>Langlotz, CP</au><au>Slosman, F</au><au>Rubesin, SE</au><au>Horii, SC</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic criteria for fatty infiltration of the liver on contrast- enhanced helical CT</atitle><jtitle>American journal of roentgenology (1976)</jtitle><addtitle>AJR Am J Roentgenol</addtitle><date>1998-09-01</date><risdate>1998</risdate><volume>171</volume><issue>3</issue><spage>659</spage><epage>664</epage><pages>659-664</pages><issn>0361-803X</issn><eissn>1546-3141</eissn><coden>AAJRDX</coden><abstract>The purpose of the study was to develop quantitative and qualitative criteria for diagnosing fatty liver on contrast-enhanced helical CT.
Differential liver-spleen attenuation was evaluated between 80 and 120 sec after injection in 76 patients who underwent contrast-enhanced helical CT. Unenhanced CT images had earlier established fatty liver when the liver minus spleen attenuation difference was less than or equal to -10 H (n = 18). Four observers who had not seen the unenhanced images used contrast-enhanced CT images to assess the presence of fatty liver on a five-point Likert scale, the presence of geographic areas spared from fatty infiltration, and the relative liver-spleen attenuation. The diagnostic accuracies of various imaging criteria were compared using McNemar's chi-square test (for sensitivity and specificity) and analysis of receiver operating characteristic curves.
Sensitivity, specificity, and receiver operating characteristic curve areas for observers' qualitative judgments were 54%, 95%, and .91, respectively; for quantitative differential liver-spleen attenuation (80-100 sec; -20.5 H discriminatory value), the values were 86%, 87%, and .94, respectively; and for quantitative differential liver-spleen attenuation (101-120 sec; -18.5 H discriminatory value), the values were 93%, 93%, and .98, respectively. Differential liver-spleen attenuation was time-dependent; overlap was noted between healthy subjects and patients with fatty liver. Qualitatively, geographic sparing was highly specific (94%) for fatty liver, whereas liver attenuation greater than or equal to spleen attenuation excluded fatty liver in all but one case.
Although quantitative and qualitative criteria for diagnosing fatty liver on helical CT can be determined, they are protocol-specific. Limited unenhanced hepatic CT remains the optimal technique for detection of fatty infiltration of the liver.</abstract><cop>Leesburg, VA</cop><pub>Am Roentgen Ray Soc</pub><pmid>9725292</pmid><doi>10.2214/ajr.171.3.9725292</doi><tpages>6</tpages></addata></record> |
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| source | American Roentgen Ray Society; MEDLINE; Alma/SFX Local Collection |
| subjects | Biological and medical sciences Contrast Media Digestive system Fatty Liver - diagnostic imaging Female Gastroenterology. Liver. Pancreas. Abdomen Humans Image Processing, Computer-Assisted Investigative techniques, diagnostic techniques (general aspects) Iothalamate Meglumine Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Medical sciences Middle Aged Other diseases. Semiology Prospective Studies Radiodiagnosis. Nmr imagery. Nmr spectrometry ROC Curve Sensitivity and Specificity Tomography, X-Ray Computed - methods |
| title | Diagnostic criteria for fatty infiltration of the liver on contrast- enhanced helical CT |
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