• Alessandra Carvalho Goulart, OliveiraIlka Regina Souza deIRRadiology Department, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, Brasil., Airlane Pereira Alencar, Maira Solange Camara dos Santos, Itamar Souza Santos, MartinesBrenda Margatho RamosBMRadiology Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil., Danilo Peron Meireles, João Augusto dos Santos Martines, Giovanni Misciagna, Isabela Martins Benseñor, and Paulo Andrade Lotufo.
• Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, Brasil.
• Sao Paulo Med J. 2015 Mar 1; 133 (2): 115124115-24.

Context And ObjectiveNoninvasive strategies for evaluating non-alcoholic fatty liver disease (NAFLD) have been investigated over the last few decades. Our aim was to evaluate the diagnostic accuracy of a new hepatic ultrasound score for NAFLD in the ELSA-Brasil study.Design And SettingsDiagnostic accuracy study conducted in the ELSA center, in the hospital of a public university.MethodsAmong the 15,105 participants of the ELSA study who were evaluated for NAFLD, 195 individuals were included in this sub-study. Hepatic ultrasound was performed (deep beam attenuation, hepatorenal index and anteroposterior diameter of the right hepatic lobe) and compared with the hepatic steatosis findings from 64-channel high-resolution computed tomography (CT). We also evaluated two clinical indices relating to NAFLD: the fatty liver index (FLI) and the hepatic steatosis index (HSI).ResultsAmong the 195 participants, the NAFLD frequency was 34.4%. High body mass index, high waist circumference, diabetes and hypertriglyceridemia were associated with high hepatic attenuation and large anteroposterior diameter of the right hepatic lobe, but not with the hepatorenal index. The hepatic ultrasound score, based on hepatic attenuation and the anteroposterior diameter of the right hepatic lobe, presented the best performance for NAFLD screening at the cutoff point ≥ 1 point; sensitivity: 85.1%; specificity: 73.4%; accuracy: 79.3%; and area under the curve (AUC 0.85; 95% confidence interval, CI: 0.78-0.91)]. FLI and HSI presented lower performance (AUC 0.76; 95% CI: 0.69-0.83) than CT.ConclusionThe hepatic ultrasound score based on hepatic attenuation and the anteroposterior diameter of the right hepatic lobe has good reproducibility and accuracy for NAFLD screening.

29 keywords...

hide…