Diagnostic criteria for fatty liver CT

Fatty liver is a common disease in clinical medicine. The risk of this disease is relatively high, so it must be detected and treated early. Before being diagnosed with fatty liver, the patient needs to go to the hospital for certain examinations. There are many specific examination items, and CT examination is one of them. So, what are the CT diagnostic criteria for fatty liver? The following will introduce relevant knowledge to you!

1. CT diagnostic criteria for fatty liver

When the CT value of the liver is lower than that of the spleen (the ratio of liver to spleen CT value is less than 1), fatty liver can be diagnosed.

According to the standards set by the Chinese Medical Association's Hepatology Branch, a liver/spleen CT ratio of 1.0 to 0.7 indicates mild fatty liver, 0.7 to 0.5 indicates moderate fatty liver, and <0.5 indicates severe fatty liver.

Normally, the density of liver parenchyma is higher than that of intrahepatic blood vessels. According to the relative density of liver, spleen and intrahepatic blood vessels, fatty liver is divided into three types: mild, moderate and severe:

(1) The liver density is reduced, and its CT value is slightly lower than that of the spleen (0.7 < liver/spleen CT ratio ≤ 1.0); there is no significant difference in the density of liver parenchyma and hepatic blood vessels, and the hepatic blood vessels are obliterated, indicating mild fatty liver;

(2) The liver density is reduced and lower than that of the spleen (0.5＜liver/spleen CT ratio≤0.7); the liver parenchyma is lower than the liver vascular density, and the liver vascular inversion is not obvious in contrast with the liver parenchyma, which is moderate fatty liver;

(3) Severe fatty liver is diagnosed when liver density is significantly reduced or negative, liver/spleen CT ratio is ≤0.5, hepatic vascular inversion is obvious, and there is a clear contrast with liver parenchyma.

2. Diagnostic criteria for fatty liver

1. The liver is enlarged, flat, smooth, soft, with blunt edges, no obvious tenderness, and no other confirmed liver disease.

2. Rule out liver diseases such as chronic viral hepatitis, schistosomiasis, liver parasites, etc.

3. Those who have the above-mentioned causes of fatty liver in the past history. For example, alcoholic fatty liver has a long history of alcoholism, especially liquor with a high alcohol content. Obesity, diabetes, intravenous high-energy nutrition, use of related drugs and exposure to toxins all have their own clinical symptoms and signs and are easy to distinguish.

4. Patients with upper gastrointestinal symptoms that are difficult to explain by other reasons (should undergo gastroscopy to check for chronic gastritis, etc.) and those who have ruled out gastric neurosis.

3. Laboratory examination of fatty liver

1. Have hyperlipidemia. That is, blood triglycerides, total cholesterol, and β-lipoprotein may be significantly increased.

2. Serum aspartate aminotransferase, alanine aminotransferase, choline esterase, and alkaline phosphatase are slightly increased, but these are non-specific changes (i.e., they are not necessarily fatty liver, but can also be laboratory abnormalities of other liver diseases).

3. There are often changes in plasma globulins. Protein electrophoresis examination shows increased levels of α1-, α2- and β-globulins, especially. Increased blood bilirubin is only seen in patients with fatty liver and cholestasis.