1. Which clinical and sonographic parameters may be useful to discriminate NASH from steatosis?
- Author
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Enrico Maria Zardi, Beniamino Sadun, Giorgia Ghittoni, Bruno Palmentieri, Marcello Persico, Ilario de Sio, Paola Roselli, and Eugenio Caturelli
- Subjects
Nonalcoholic steatohepatitis ,Adult ,Male ,medicine.medical_specialty ,Pathology ,Biopsy ,digestive system ,Gastroenterology ,Diagnosis, Differential ,Internal medicine ,Histological diagnosis ,Diagnosis ,medicine ,Adult, Biopsy, Diagnosis ,Differential, Fatty Liver ,diagnosis/pathology/ultrasonography, Female, Humans, Liver ,pathology/ultrasonography, Male, Middle Aged, Organ Size, Retrospective Studies, Spleen ,metabolism ,Humans ,Retrospective Studies ,Ultrasonography ,medicine.diagnostic_test ,business.industry ,Fatty liver ,diagnosis/pathology/ultrasonography ,nutritional and metabolic diseases ,Retrospective cohort study ,Organ Size ,Middle Aged ,medicine.disease ,pathology/ultrasonography ,digestive system diseases ,humanities ,body regions ,Natural history ,Fatty Liver ,Liver ,Liver biopsy ,Differential ,Female ,Steatosis ,business ,Spleen - Abstract
The natural history of nonalcoholic steatohepatitis (NASH) includes the passage through steatosis.To retrospectively evaluate the usefulness of sonographic parameters compared to histological diagnosis when differentiating steatosis from NASH.This retrospective study reviewed records of patients with steatosis from databases of our Departments, selecting only those who had been diagnosed by sonography and liver biopsy [64 males (63.82%); 30 females (36.18%)].Attenuation of the echo amplitude (P0.05; odds ratio (OR): 3.43; confidence interval (CI): 1.02-11.57), focal fat sparing (P0.05; OR: 3; CI: 1.02-11.88) and splenic diameter (P0.05; OR: 1.66; CI: 1.04-3.26) were independent predictors of NASH. A significantly higher association of attenuation of the echo amplitude, enlarged splenic diameter, and presence of focal fat sparing was observed in NASH patients (P0.01).It is very difficult to build a predictive system to distinguish NASH from steatosis based on sonographic scores. However, it is already possible to differentiate NASH from steatosis by combining 3 simple sonographic parameters: attenuation of the echo amplitude, enlarged splenic diameter, and presence of focal fat sparing.
- Published
- 2010