Diagnosis of fatty infiltration of the liver on contrast enhanced CT: limitations of liver-minus-spleen attenuation difference measurements (original) (raw)
Abstract
Background: We investigated whether liver-minus-spleen (L-S) attenuation differences can accurately diagnose fatty infiltration of the liver on contrast-enhanced computed tomography (CT).
Methods: A group of 78 patients administered a fast injection (90-s duration) of 150 mL 60% ionic contrast was compared with 81 patients given a slow injection (152.5 s). The presence or absence of fatty infiltration of the liver was diagnosed by noncontrast CT.
Results: The L-S attenuation differences varied significantly, depending on both injection rate and timing of measurements. For the fast-injection group, the optimal L-S threshold for diagnosing fatty infiltration ranged from −43 to −33 Hounsfield units (HU) for early (79 s) and late measurements (106 s), respectively. For the slow-injection group, the optimal threshold ranged from −31 to −25 HU (80 and 112 s, respectively). In addition, sensitivity was not very high (range = 0.54–0.71) for either injection protocol at any measurement time because of significant overlap of L-S values between normal and fatty infiltration patients. Moderate and severe fatty infiltration were more reliably diagnosed than mild fatty infiltration by this method.
Conclusions: Contrast injection rate and timing of measurements significantly influence the optimal L-S threshold for diagnosing fatty liver. This limits the clinical usefulness of such measurements.
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Authors and Affiliations
- Department of Radiology, Veterans Affairs Medical Center, Stop 114, 1055 Clermont Street, Denver, CO, 80220, USA
R. J. Johnston - Department of Radiology, Box C277, University of Colorado Health Sciences Center, 4200 E. 9th Avenue, Denver, CO, 80262, USA
E. R. Stamm, J. M. Lewin & R. E. Hendrick - Department of Preventive Medicine and Biometrics, Box B119, University of Colorado Health Sciences Center, 4200 E. 9th Avenue, Denver, CO, 80262, USA
P. G. Archer
Authors
- R. J. Johnston
- E. R. Stamm
- J. M. Lewin
- R. E. Hendrick
- P. G. Archer
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Johnston, R., Stamm, E., Lewin, J. et al. Diagnosis of fatty infiltration of the liver on contrast enhanced CT: limitations of liver-minus-spleen attenuation difference measurements.Abdom Imaging 23, 409–415 (1998). https://doi.org/10.1007/s002619900370
- Received: 16 September 1996
- Accepted: 19 February 1997
- Published: 03 February 2014
- Issue date: July 1998
- DOI: https://doi.org/10.1007/s002619900370