Computer-Assisted Ultrasound Analysis of Liver Echogenicity in Obese and Normal-Weight Children

OBJECTIVE: No simple computer-assisted method for assessing liver echogenicity has been developed to date. This study describes an accessible and reproducible computer-assisted method for measuring liver echogenicity in obese (body mass index [BMI] >/= 97th percentile) and normal-weight (BMI from 25th to 75th percentile) children and correlates the results with laboratory test results. SUBJECTS AND METHODS: Twenty-two children (age range, 6-11 years) were assigned to one of two groups of 11 children each and paired by sex and age. All children underwent ultrasound, anthropometric measurements, and laboratory tests. A hepatorenal index was calculated using software to analyze the difference in echogenicity between the liver parenchyma and kidney cortex. The Student's t test and Mann-Whitney U test were used for statistical analyses. RESULTS: The hepatorenal index was statistically different between the obese and normal-weight children (33.9 +/- 6.6 vs 14.1 +/- 6.1, p < 0.001). The analysis of laboratory tests of obese and normal-weight children revealed statistically significant differences in the values of glucose (p = 0.034), insulin (p = 0.008), triglycerides (p = 0.036), uric acid (p < 0.001), and alkaline phosphatase (p = 0.045). CONCLUSION: Computer-assisted analysis of ultrasound liver echogenicity using the software is an accessible, reproducible, and easy-to-use diagnostic tool for calculating the hepatorenal index. This tool may be used for follow-up and control in the treatment of fat infiltration in the liver of obese children.