“Characterization of the liver steatosis by ultrasonography in comparison to the MRI”
Mohamed H. Ahmed, Ahmed A. Ahmed, Tarek M.M. Mansour, Yasser A. Ahmed, Mohamed M. AlbaroudiBackground and aim
Hepatic steatosis (HS) is the key manifestation of non-alcoholic fatty liver disease and refers to the excess of fat within the hepatocytes, histologically defined by the presence of at least 5% of hepatocytes containing fat. The aim of this work was to correlate conventional ultrasonography (US) findings with the proton density fat fraction measured by MRI to assess the diagnosis performance of US in predicting the presence and severity of HS.
Patients and methods
A cross-sectional study was carried out on 50 patients diagnosed with HS. All patients were subjected to radiological evaluation (US and MRI examination).
Results
The US demonstrated high diagnostic accuracy across all MRI-defined stages of steatosis. For Stage 1, 76.9% were correctly identified, with some misclassification into higher stages. Stage 2 and Stage 3 showed perfect classification accuracy (100%) by US. Agreement analysis revealed substantial to near-perfect concordance with MRI: Cohen’s Kappa values were 0.831 for Stage 1, 0.918 for Stage 2, and 0.956 for Stage 3. True positive rates were high across all stages, with minimal false positives and false negatives, confirming US’s strong performance in detecting moderate to severe HS.
Conclusion
US demonstrates high reliability and accuracy (94–98%) in assessing HS compared with MRI, especially in moderate to severe cases (Stages 2 and 3). With strong agreement rates (Cohen’s Kappa 0.831–0.956), it proves to be a cost-effective and accessible diagnostic tool, particularly suitable for resource-limited settings.