Diffuse hepatic steatosis (grading)
Grading of diffuse hepatic steatosis on ultrasound has been used to communicate to the clinician about the extent of fatty changes in the liver.
- grade I: diffusely increased hepatic echogenicity but periportal and diaphragmatic echogenicity is still appreciable
- grade II: diffusely increased hepatic echogenicity obscuring periportal echogenicity but diaphragmatic echogenicity is still appreciable
- grade III: diffusely increased hepatic echogenicity obscuring periportal as well as diaphragmatic echogenicity
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.
- 1. Singh D, Das CJ, Baruah MP. Imaging of non alcoholic fatty liver disease: A road less travelled. Indian J Endocrinol Metab. 2013;17 (6): 990-5. doi:10.4103/2230-8210.122606 - Free text at pubmed - Pubmed citation
- 2. Perez NE, Siddiqui FA, Mutchnick MG et-al. Ultrasound diagnosis of fatty liver in patients with chronic liver disease: a retrospective observational study. J. Clin. Gastroenterol. 2007;41 (6): 624-9. doi:10.1097/01.mcg.0000225680.45088.01 - Pubmed citation
- 3. Strauss S, Gavish E, Gottlieb P et-al. Interobserver and intraobserver variability in the sonographic assessment of fatty liver. AJR Am J Roentgenol. 2007;189 (6): W320-3. doi:10.2214/AJR.07.2123 - Pubmed citation
- 4. Brunt EM, Janney CG, Di Bisceglie AM et-al. Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions. Am. J. Gastroenterol. 1999;94 (9): 2467-74. doi:10.1111/j.1572-0241.1999.01377.x - Pubmed citation
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