Evaluation des hepatorenalen Index zur nicht-invasiven Bestimmung des Steatosegrades der Leber bei chronisch Leberkranken mit der Histologie als Referenzstandard

Evaluation of the hepatorenal index for non-invasive graduation of steatosis of the liver in patients with chronic liver disease using histology as a reference standard

by Julian Klemens Lasser
Doctoral thesis
Date of Examination:2022-08-04
Date of issue:2022-08-04
Advisor:PD Dr. Steffen Kunsch
Referee:PD Dr. Steffen Kunsch
Referee:Prof. Dr. Johannes Uhlig
Persistent Address: http://dx.doi.org/10.53846/goediss-9387

 

 

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Abstract

English

The aim of the study was to evaluate the accuracy of the hepatorenal index (HRI) measured by high-end ultrasound devices for the determination and classification of hepatosteatosis in patients with different chronic liver diseases. Patients with chronic liver disease who underwent liver biopsy and ultrasonography between March 2016 and May 2019 were included in the retrospective study. Sonographic determined HRI was correlated with the histological graduation (S0 (<5% fat), S1 (≥5–33%), S2 (>33–66%) and S3 (>66%). Interrater reliability was also calculated. 157 patients were evaluated. An HRI cut-off value of 1.46 was calculated to differentiate between patients with hepatosteatosis and patients without hepatosteatosis, with a sensitivity of 42.7% and specificity of 90.7% (AUROC 0.680). There was no correlation in the subgroup of individuals who did not have alcoholic fatty liver disease (NAFLD) as a leading chronic liver disease. Furthermore, a decrese in measurement accuracy was observed in subjects with concomitant second-degree fibrosis or higher and an improvement in measurement accuracy was observed in subjects with lower than second-degree fibrosis. The Interobserver agreement of HRI was excellent. In conclusion, there is a high correlation between HRI and histologically determined degree of hepatosteatosis. Nevertheless, HRI is not suitable to prevail over other non-invasive diagnostic methods in hepatosteatosis diagnosis. (Abstract adapted from Golo Petzold et al., PLOS ONE, 2020).
Keywords: Hepatorenal Index
 
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