Diffuse hepatic steatosis (grading)
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Grading of diffuse hepatic steatosis on ultrasound has been used to communicate to the clinician about the extent of fatty changes in the liver.
- grade I: diffusely increased hepatic echogenicity but periportal and diaphragmatic echogenicity is still appreciable
- grade II: diffusely increased hepatic echogenicity obscuring periportal echogenicity but diaphragmatic echogenicity is still appreciable
- grade III: diffusely increased hepatic echogenicity obscuring periportal as well as diaphragmatic echogenicity
Some suggest that visual grading of hepatic steatosis is subject to a wide interobserver and intraobserver variability 3.
There is also a histological three point scale for grading severity of non-alcoholic steatohepatitis 4. These two grading systems are not currently correlated.
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- 4. Brunt EM, Janney CG, Di Bisceglie AM et-al. Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions. Am. J. Gastroenterol. 1999;94 (9): 2467-74. doi:10.1111/j.1572-0241.1999.01377.x - Pubmed citation