Prevalence and sonographic changes compatible with fatty liver disease in patients referred for abdominal ultrasound examination in Aracaju, SE

Comparison of size of the liver between patients with non-alcoholic fatty liver disease and healthy controls

Background

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease across all age groups. Limited studies have been conducted to consider the relationship between NAFLD and liver size. This study aimed to compare the size of the liver between NAFLD patients and healthy controls.

Methods

This case-control study was conducted on NAFLD patients (n = 300), and healthy subjects (n = 300) referred to the Golestan Hospital of Ahvaz from April to August 2021. All individuals underwent ultrasonography examination, and liver size was measured in the midclavicular line. Fatty liver was divided into three grades, I (mild), II (moderate), and III (severe), according to the disease severity. Anthropometric parameters, including age, sex, weight, height, and body mass index (BMI), were recorded. Finally, the size of the liver and its relationship with NAFLD and anthropometric parameters was evaluated.

Results

Patients had significantly higher weight, and BMI mean values than controls (P < 0.001). In comparison to controls, NAFLD patients had considerably larger livers on average. (149.05 ± 12.60 mm vs. 134.51 ± 12.09; P < 0.001). There was a significant tendency for larger liver size in normal to severe fatty liver patients (P < 0.001). In patients with mild, moderate, and severe NAFLD, the mean liver size was 144.34 ± 11.35, 154.21 ± 10.84, and 158.63 ± 13.45 mm, respectively. The mean liver size in both groups was significantly higher in males than females (P < 0.05). Age (P = 0.037), sex (P < 0.001), height (P < 0.001), BMI (P = 0.008), and steatosis (P < 0.001) were independent variables for predicting the liver size.

Conclusion

The liver size of persons with fatty liver was substantially more considerable than healthy people. The size of the liver was substantially linked with sex, age, BMI, fatty liver, and hepatic steatosis grade. A straightforward way to predict fatty liver is to use ultrasonography to determine the size of the liver.

Frequency of hepatic steatosis and its association with the pneumonia severity score on chest computed tomography in adult COVID-19 patients

BACKGROUND

Recent studies of the coronavirus disease 2019 (COVID-19) demonstrated that obesity is significantly associated with increased disease severity, clinical outcome, and mortality. The association between hepatic steatosis, which frequently accompanies obesity, and the pneumonia severity score (PSS) evaluated on computed tomography (CT), and the prevalence of steatosis in patients with COVID-19 remains to be elucidated.

AIM

To assess the frequency of hepatic steatosis in the chest CT of COVID-19 patients and its association with the PSS.

METHODS

The chest CT images of 485 patients who were admitted to the emergency department with suspected COVID-19 were retrospectively evaluated. The patients were divided into two groups as COVID-19-positive [CT- and reverse transcriptase-polymerase chain reaction (RT-PCR)-positive] and controls (CT- and RT-PCR-negative). The CT images of both groups were evaluated for PSS as the ratio of the volume of involved lung parenchyma to the total lung volume. Hepatic steatosis was defined as a liver attenuation value of ≤ 40 Hounsfield units (HU).

RESULTS

Of the 485 patients, 56.5% (n = 274) were defined as the COVID-19-positive group and 43.5% (n = 211) as the control group. The average age of the COVID-19-positive group was significantly higher than that of the control group (50.9 ± 10.9 years vs 40.4 ± 12.3 years, P < 0.001). The frequency of hepatic steatosis in the positive group was significantly higher compared with the control group (40.9% vs 19.4%, P < 0.001). The average hepatic attenuation values were significantly lower in the positive group compared with the control group (45.7 ± 11.4 HU vs 53.9 ± 15.9 HU, P < 0.001). Logistic regression analysis showed that after adjusting for age, hypertension, diabetes mellitus, overweight, and obesity there was almost a 2.2 times greater odds of hepatic steatosis in the COVID-19-positive group than in the controls (odds ratio 2.187; 95% confidence interval: 1.336-3.580, P < 0.001).

CONCLUSION

The prevalence of hepatic steatosis was significantly higher in COVID-19 patients compared with controls after adjustment for age and comorbidities. This finding can be easily assessed on chest CT images.

Fat-containing liver lesions: a pictorial review

The aim of this pictorial essay is to review the spectrum of fat-containing liver lesions and their characterisation on magnetic resonance imaging with focus on the radiological features that aid in the differential diagnoses. Fat-containing liver lesions comprise a heterogeneous group of tumours with variable imaging findings. Magnetic resonance imaging clearly displays the micro- and macroscopic fat components of the lesions and other characteristic features that are helpful tools to make the differential diagnosis.

Computed tomography angiography study of variations of the celiac trunk and hepatic artery in 100 patients

Objective

To describe the main anatomical variations of the celiac trunk and the hepatic artery at their origins.

Materials and Methods

This was a prospective analysis of 100 consecutive computed tomography angiography studies of the abdomen performed during a one-year period. The findings were stratified according to classification systems devised by Sureka et al. and Michels.

Results

The celiac trunk was "normal" (i.e., the hepatogastrosplenic trunk and superior mesenteric artery originating separately from the abdominal aorta) in 43 patients. In our sample, we identified four types of variations of the celiac trunk. Regarding the hepatic artery, a normal anatomical pattern (i.e., the proper hepatic artery being a continuation of the common hepatic artery and bifurcating into the right and left hepatic arteries) was seen in 82 patients. We observed six types of variations of the hepatic artery.

Conclusion

We found rates of variations of the hepatic artery that are different from those reported in the literature. Our findings underscore the need for proper knowledge and awareness of these anatomical variations, which can facilitate their recognition and inform decisions regarding the planning of surgical procedures, in order to avoid iatrogenic intraoperative injuries, which could lead to complications.