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.
ZHANG Hong-Xi,YANG Hui-Ping,LAI Can et al. Diagnostic value of ultrasonographic examination for hepatic steatosis in obese children[J]. CJCP, 2014, 16(9): 873-877.
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