A Random Comparative Study Between CT And Usg Grading Of Fatty Changes In Liver

Objectives:The aim of this randomized study is to evaluate diagnostic value of grading system used for severity of fatty changes in liver using two imaging modalities, computed tomography (CT) and ultrasonography (USG).Methods:In this randomized study,160 patients with plain CT scan documented with fatty changes in liver were selected. In the same patients, USG examination was done within a difference period of 3-5days. All the selected patient's plain CT scan were reviewed on a Picture Archiving and Communication System (PACS) of our hospital and were graded as mild, moderate and severe hepatic steatosis with liver-to-spleen ratio of 0.9-0.85,0.84-0.53 and≤0.52 respectively. The same patient's USG grading as normal, mild, moderate and severe accessed visually by ultrasonologist was recorded. Wilcoxon Signed Ranks test were used to see any statistical significance between CT grades and USG grades.Result:A total of 160 patients with age ranging from 18-65 years (mean age 41±13.36) were selected for this randomized study. The results in 160 cases of fatty changes in liver diagnosed with CT, the ultrasound examination showed 20 cases of normal liver (12.5%),8 cases mild fatty changes (5%),117 cases of moderate fatty changes (73.1%) and 15 cases of severe fatty changes (9.4%). In 26 cases of mild fatty changes in liver diagnosed by CT, the USG examination showed 20 cases of normal liver (76.9%),4 cases of mild fatty changes (15.4%) and 2 cases of moderate fatty changes (7.7%). In 122 cases of moderate fatty changes in liver diagnosed by CT, the USG examination showed 4 cases mild fatty changes (3.3%),115 cases of moderate fatty changes (94.3%) and 3 cases of severe fatty changes (2.4%). In 12 cases of severe fatty changes in liver, both CT and USG gave the same result.Conclusion:In our study, the presence of fat in liver can be documented with both imaging modalities, CT and USG. Both modalities are effective means of identifying moderate to severe degree of fatty changes in liver. Although both can identify the presence of fat, CT is more sensitive and accurate than ultrasonographic examination in diagnosing mild fatty changes in liver.