Diffuse hepatic steatosis (grading)

Last revised by Jeremy Jones ◉ on 20 Sep 2021

Citation, DOI, disclosures and article data

Citation:

Goel A, Jones J, Di Muzio B, et al. Diffuse hepatic steatosis (grading). Reference article, Radiopaedia.org (Accessed on 21 Sep 2023) https://doi.org/10.53347/rID-33279

DOI:

https://doi.org/10.53347/rID-33279

Permalink:

https://radiopaedia.org/articles/33279

rID:

33279

Article created:

6 Jan 2015, Ayush Goel ◉

Disclosures:

At the time the article was created Ayush Goel had no recorded disclosures.

View Ayush Goel's current disclosures

Last revised:

20 Sep 2021, Jeremy Jones ◉

Disclosures:

At the time the article was last revised Jeremy Jones had no recorded disclosures.

View Jeremy Jones's current disclosures

Revisions:

16 times, by 6 contributors - see full revision history and disclosures

Systems:

Hepatobiliary

Sections:

Classifications

Tags:

cases, ultrasound, liver, hepatic steatosis

Synonyms:

Grading of fatty liver

Grading of diffuse hepatic steatosis on ultrasound has been used to communicate to the clinician about the extent of fatty changes in the liver.

Grading

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

Practical points

It is important not to fall into the pitfall that all diffusely echogenic livers are fatty, other pathologies may produce identical appearances, including cirrhosis.

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.