Diagnostic value of ultrasonographic examination for hepatic steatosis in obese children

ZHANG Hong-Xi; YANG Hui-Ping; LAI Can; HE Jing; YE Jing-Jing; FU Jun-Fen

doi:10.7499/j.issn.1008-8830.2014.09.001

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Chinese Journal of Contemporary Pediatrics ›› 2014, Vol. 16 ›› Issue (9) : 873-877. DOI: 10.7499/j.issn.1008-8830.2014.09.001

CLINICAL RESEARCH

Diagnostic value of ultrasonographic examination for hepatic steatosis in obese children

ZHANG Hong-Xi¹, YANG Hui-Ping², LAI Can¹, HE Jing¹, YE Jing-Jing¹, FU Jun-Fen¹

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Abstract

Objective To evaluate the sensitivity and specificity of hepatic ultrasonography（US) for the diagnosis of hepatic steatosis in obese children, using ¹H magnetic resonance spectroscopy（¹H MRS) as the reference standard.Methods A total of 162 obese children with age of 10.5±2.2 years and BMI of 28±4 were enrolled in this study. They accepted hepatic US and ¹H MRS examinations. The sensitivity, specificity, positive predictive value（PPV) and negative predictive value（NPV) of US were calculated for the overall presence of hepatic steatosis by comparison with ¹H MRS results. Results Using quantitative criteria of liver fat content（LFC) >5% determined by ¹H MRS, 95 children(58.6%) were diagnosed as having hepatic steatosis. The sensitivity and specificity of US in diagnosing steatosis were 91.6%（87/95) and 50.7%（34/67) respectively, with PPV of 72.5%（87/120), and NPV of 81.0%（34/42). Considerable overlap in LFC measured by ¹H MRS was observed between different grades from US findings: absent（LFC interquartile range:1.3%-3.9%), mild（2.4%-10.7%), moderate（7.1%-20.2%) and severe（7.6%-28.8%) steatosis. Conclusion The US can yield a high sensitivity and low specificity in the diagnosis of hepatic steatosis in obese children, suggesting it can be used as a screening tool for hepatic steatosis. To improve diagnostics, ¹H MRS is needed to determine LFC.

Key words

Ultrasonography / ¹H magnetic resonance spectroscopy / Obesity / Hepatic steatosis / Child

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ZHANG Hong-Xi, YANG Hui-Ping, LAI Can, HE Jing, YE Jing-Jing, FU Jun-Fen. Diagnostic value of ultrasonographic examination for hepatic steatosis in obese children[J]. Chinese Journal of Contemporary Pediatrics. 2014, 16(9): 873-877 https://doi.org/10.7499/j.issn.1008-8830.2014.09.001

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