Journal of Korean Society of Ultrasound in Medicine 2012;31(4): 219-224.
Correlation between Abdominal Fat Amount and Fatty Liver, using Liver to Kidney Echo Ratio on Ultrasound.
Yang Shin Park, Chang Hee Lee, Kyung Mook Choi, Jongmee Lee, Jae Woong Choi, Kyeong Ah Kim, Cheol Min Park
1Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
2Department of Internal Medicine (Division of Endocrinology and Metabolism), Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
  Published online: December 31, 2012.
PURPOSE: It has been generally recognized that fatty liver can often be seen in the obese population. This study was conducted in order to evaluate the association between fatty liver and abdominal fat volume. MATERIALS AND METHODS: A total of 105 patients who visited our obesity clinic in the recent three years underwent fat CT scans and abdominal US. Attenuation difference between liver and spleen on CT was considered as a reference standard for the diagnosis of fatty liver. On US, the echogenicity of the liver parenchyma was measured in three different regions of interest (ROI) close to the adjacent right kidney in the same slice, avoiding vessels, bile duct, and calcification. Similar measurements were performed in the right renal cortex. The mean values were calculated automatically on the histogram of the ROI using the PACS program. The hepatorenal echogenicity ratio (HER; mean hepatic echogenicity/mean renal echogenicity) was then calculated. Abdominal fat volume was measured using a 3 mm slice CT scan at the L4/5 level and was calculated automatically using a workstation. Abdominal fat was classified according to total fat (TF), visceral fat (VF), and subcutaneous fat (SF). We used Pearson's bivariate correlation method for assessment of the correlation between HER and TF, VF, and SF, respectively. RESULTS: Significant correlation was observed between HER and abdominal fat (TF, VF, and SF). HER showed significant correlation with VF and TF (r = 0.491 and 0.402, respectively; p = 0.000). The correlation between HER and SF (r = 0.255, p = 0.009) was less significant than for VF or TF. CONCLUSIONS: Fat measurement (HER) by hepatic ultrasound correlated well with the amount of abdominal fat. In particular, the VF was found to show a stronger association with fatty liver than SF.
Keywords: Fatty liver; Obesity; Ultrasound; Abdominal fat; Visceral fat
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