Diffuse hepatic steatosis (grading)
Updates to Article Attributes
Body
was changed:
Grading of diffuse hepatic steatosis on ultrasound has been used to communicate to the clinician about the extent of fatty changes in the liver.
Grading
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grade I:diffusely increased hepatic echogenicity
with visiblebut periportal and diaphragmatic echogenicity is still appreciable -
grade II:
increaseddiffusely increased hepatic echogenicitywith imperceptibleobscuring periportal echogenicity, without obscuration of diaphragmbut diaphragmatic echogenicity is still appreciable -
grade III:
increaseddiffusely increased hepatic echogenicitywith imperceptibleobscuring periportal as well as diaphragmatic echogenicityand obscuration of diaphragm
Practical points
Some suggest that visual grading of hepatic steatosis is subject to a wide interobserver and intraobserver variability 3.
There is also a histological three point scale for grading severity of non-alcoholic steatohepatitis 4. These two grading systems are not currently correlated.
-<strong>grade I: </strong>increased hepatic echogenicity with visible periportal and diaphragmatic echogenicity</li>- +<strong>grade I: </strong>diffusely increased hepatic echogenicity but periportal and diaphragmatic echogenicity is still appreciable</li>
-<strong>grade II:</strong> increased hepatic echogenicity with imperceptible periportal echogenicity, without obscuration of diaphragm</li>- +<strong>grade II:</strong> diffusely increased hepatic echogenicity obscuring periportal echogenicity but diaphragmatic echogenicity is still appreciable </li>
-<strong>grade III:</strong> increased hepatic echogenicity with imperceptible periportal echogenicity and obscuration of diaphragm</li>- +<strong>grade III:</strong> diffusely increased hepatic echogenicity obscuring periportal as well as diaphragmatic echogenicity </li>
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