Diagnosis of hepatic steatosis by contrast-enhanced abdominal computed tomography

• Autor(a) principal: Monjardim, Rodrigo da Fonseca
• Data de Publicação: 2013
• Outros Autores: Costa, Danilo Manuel Cerqueira, Romano, Ricardo Francisco Tavares, Salvadori, Priscila Silveira, Santos, Jaime de Vargas Conde dos, Atzingen, Augusto Castelli von [UNIFESP], Shigueoka, David Carlos [UNIFESP], D'Ippolito, Giuseppe [UNIFESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0100-39842013000300005; http://repositorio.unifesp.br/handle/11600/7802
• topic: Fatty liver; Steatosis; Liver disease; Tomography; Multidetector computed tomography; Contrast media; Figado gorduroso; Esteatose hepatica; Hepatopatias; Tomografia; Tomografia computadorizada multidetectores; Meios de contraste

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.