Yajima Y, Ohta K, Narui T, Abe R, Suzuki H, Ohtsuki M
Tohoku J Exp Med. 1983 Jan;139(1):43-50. doi: 10.1620/tjem.139.43.
In order to investigate the reliability of ultrasonography in the diagnosis of fatty liver, retrospective evaluation was made of abdominal echograms in 45 patients with various diffuse liver diseases who underwent liver biopsy within 2 weeks after the ultrasound study. Instead of the well-recognized but subjective diagnostic criterion, i.e. the bright liver pattern, liver-kidney contrast is proposed as a new criterion. The liver-kidney contrast is based on the brightness of the liver in comparison to the renal parenchyma where fatty change seldom occurs. Combination of this liver-kidney contrast with two other well-known ultrasonographical findings of fatty liver, vascular blurring and deep attenuation, enables us to grade fatty change semiquantitatively. When fatty change of over 30% in the hepatic lobule was adopted as the definition of fatty liver, the satisfaction of both liver-kidney contrast and vascular blurring presented an ultrasound diagnostic criterion for fatty liver, with sensitivity of 83%, specificity of 100%, and an accuracy of 96%.
为了研究超声检查在诊断脂肪肝方面的可靠性，我们对45例患有各种弥漫性肝病的患者进行了回顾性评估，这些患者在超声检查后2周内接受了肝活检。我们提出以肝-肾对比度作为新的诊断标准，取代了公认但主观的诊断标准，即肝脏明亮模式。肝-肾对比度是基于肝脏与很少发生脂肪变性的肾实质相比的亮度。将这种肝-肾对比度与另外两个众所周知的脂肪肝超声检查结果（血管模糊和深部衰减）相结合，使我们能够对脂肪变性进行半定量分级。当采用肝小叶中超过30%的脂肪变性作为脂肪肝的定义时，肝-肾对比度和血管模糊两者均符合的情况提出了一种脂肪肝的超声诊断标准，其敏感性为83%，特异性为100%，准确性为96%。
