Original InvestigationLow-dose Unenhanced CT for IV Contrast Bolus Timing:: Is It Reliable to Assess Hepatic Steatosis?
Section snippets
Patient Population
Institutional review board approval was obtained for this Health Insurance Portability and Accountability Act–compliant retrospective study. A study population of 50 patients, comprising of 21 women and 29 men, was included in this study. Indications for multiphasic MDCT were as follows: abdominal aortic aneurysm (n = 16), living related renal donor candidate (n = 5), and pancreatic mass (n = 29). Patients with focal liver lesions and patients with ascites were not included in this study. The
Quantification of Body Habitus
Abdominal circumference at the level of the pedicle of L1 ranged from 103.0 to 203.6 cm with a mean of 142.8 cm ± 22.6 cm. Pearson correlation showed a good correlation between abdominal circumference and the BMI (r = 0.83, P < .05).
Attenuation Value Assessment
Mean hepatic attenuation on unenhanced low-dose images was 57.7 HU with a range from 5.7 to 73.9 HU and mean hepatic attenuation on unenhanced standard-dose images was 56.0 HU with a range from 7.3 to 76.7 HU. Hepatic attenuation did not differ significantly between
Discussion
Percutaneous liver biopsy is considered the gold standard for diagnosis of hepatic steatosis, and although it is a relatively safe procedure, the risk of significant bleeding is 1% 13, 14, 15, 16. Many research groups have investigated the role of CT as a noninvasive tool for the assessment of steatosis 1, 2, 3, 4, 5, 6, 7, 8. The most common biomarkers for steatosis are hepatic attenuation, the liver-to-spleen attenuation ratio, the difference between hepatic and splenic attenuation, and the
Conclusion
In summary, hepatic attenuation can be reliably assessed on unenhanced low radiation dose images to estimate steatosis. This is especially helpful in cases in which no unenhanced standard radiation dose phase is acquired and a contrast bolus monitoring scan covers parts of the liver.
Acknowledgements
This investigation was supported by the Swiss National Science Foundation.
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