[Subjective evaluation and quantitative gray-scale analysis in the sonographic diagnosis of diffuse changes in the...

Two investigators were asked to evaluate independently the echogenicity, coarsening and inhomogeneity of the hepatic echo pattern in a semi-quantitative manner; they had no knowledge of the diagnosis and used the same apparatus. The three subjective criteria were largely independent from the observer. Approximately three-quarters of all patients with slightly increased echogenicity showed a subjective appearance of coarsening; the impression of inhomogeneity increased significantly with increasing echogenicity. This is of importance in the sonographic evaluation of cirrhosis of the liver and in the diagnosis of diffuse liver metastases in a fatty liver. Grey scale analysis within a region of interest showed satisfactory correlation between the measured mean grey scale and echogenicity. Standard deviation within the grey scale was redundant, and there was no correlation between the other subjective characteristics and quantitatively measurable values.