Evaluation of liver steatotic and fibrous content by computerized tomography and ultrasound

Twenty-four patients with steatotic liver underwent computerized tomography (CT) and ultrasound (US) examinations and liver biopsy, performed within a maximum interval of 6 weeks. The CT and US findings were compared with the fat and fibrous content of the biopsy specimens. A good linear inverse correlation between the CT findings and fat content was found. The ranges of CT values were 39-60 HU (mean, 52 HU) for mild fat content (less than or equal to 9.9%), 4-46 HU (mean, 27 HU) for moderate fat content (10.0-24.9%), and -6 to 19 HU (mean, 10 HU) for severe fat content (greater than or equal to 25.0%). With US it was possible to estimate roughly the fat and fibrous content of the liver. There was always the 'bright liver' finding in patients with 10.0% or more fat content, but it was impossible to estimate the content of fat more accurately. 'Bright liver' was also found in most patients with mildly and in all patients with severely increased fibrous content. It was impossible to differentiate the latter from each other or from the 'bright liver' caused by fatty degeneration.