COMPARATIVE DIAGNOSTIC ACCURACY OF ULTRASONOGRAPHIC FATTY LIVER INDICATOR (US-FLI) AND COMPUTED TOMOGRAPHY (CT) ATTENUATION IN GRADING HEPATIC STEATOSIS: A STUDY IN AN INDUSTRIAL COHORT OF WEST BENGAL.
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Keywords
Radio-diagnosis, Ultrasonographic Fatty Liver Indicator, Hepatic Steatosis, Computed Tomography, Durgapur.
Abstract
Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is rapidly becoming a silent epidemic in the industrial belts of West Bengal. While liver biopsy is the gold standard, non-invasive radiological grading is essential for large-scale screening. This study evaluates the diagnostic efficacy of the Ultrasonographic Fatty Liver Indicator (US-FLI) compared to CT-based hepatic attenuation in an industrial population.
Methods: A cross-sectional diagnostic study was conducted at a tertiary hospital in Durgapur involving 250 adult subjects from nearby industrial units. All participants underwent transabdominal ultrasonography (USG) using a 3.5–5 MHz probe to determine the US-FLI score (based on liver-kidney contrast, vessel blurring, and gallbladder wall definition). A subset of 80 high-risk subjects underwent non-contrast Computed Tomography (NCCT) to measure the Liver-to-Spleen (L/S) attenuation ratio in Hounsfield Units (HU).
Results: Hepatic steatosis was detected in 58.4% of the cohort via USG. The US-FLI score showed a strong inverse correlation with CT hepatic attenuation (r = -0.74, p < 0.001$). A US-FLI score of ge 4 demonstrated a sensitivity of 88% and a specificity of 82% in identifying moderate-to-severe steatosis (CT L/S ratio < 0.8). Significant diagnostic agreement (Kappa = 0.72) was observed between the two modalities for Grade II and III steatosis.
Conclusion: The US-FLI is a robust, cost-effective, and radiation-free tool for grading hepatic steatosis in resource-limited industrial settings. While CT remains superior for quantifying precise fat fraction, US-FLI offers sufficient diagnostic accuracy for routine clinical screening and monitoring of metabolic-associated fatty liver disease.
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Dr. Sumithra Bongu
Associate Professor, Department Of Radio-Diagnosis, Gouri Devi Institute Of Medical Sciences And Hospital, Durgapur
