ArticlePediatric radiology2024
Ultrasound-estimated hepatorenal index: diagnostic performance and interobserver agreement for pediatric liver fat quantification.
Article in Pediatric radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Ultrasonic radio frequency signals-based hepatorenal index improved the diagnostic performance in steatotic liver disease.Abdominal radiology (New York) · 2026Article
- Interplay of childhood metabolic dysfunction-associated steatotic liver disease and obesity in the development of youth-onset type 2 diabetes.World journal of clinical pediatrics · 2026Article
- A Systematic Review and Meta-Analysis on the Diagnostic Test Accuracy of Hepatorenal Index in Pediatric Metabolic Dysfunction-Associated Steatotic Liver Disease.Diagnostics (Basel, Switzerland) · 2026Review
- Comparison of ultrasound-derived fat fraction and hepatorenal index for quantitative detection of hepatic steatosis: a multicenter MRI-PDFF-referenced study.Frontiers in nutrition · 2026Article
- Increased Hepatorenal Index Is Associated with the Risk of Developing Stroke in Patients with Nonalcoholic Fatty Liver Disease.Current medical science · 2025Article
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7 authors.
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Abstract
backgroundSemiquantitative and quantitative sonographic techniques have the potential for screening and surveillance of children at risk of nonalcoholic fatty liver disease.
objectiveTo determine diagnostic performance and interobserver agreement of hepatorenal index (HRI) for pediatric ultrasound-based liver fat quantification. MATERIALS AND
methodsIn an institutional review board (IRB)-approved retrospective study (April 2014 to April 2023), children (< 18 years) with clinically performed magnetic resonance imaging (MRI) scans for liver fat quantification were assessed. Inclusion criteria required availability of abdominal ultrasound within 3 months of quantitative MRI. Three blinded readers subjectively assessed for sonographic hepatic steatosis and calculated HRI. MRI proton density fat fraction (PDFF) was the reference standard. Interobserver agreement, correlation with PDFF, and optimal HRI (using ROC analysis) values were analyzed. The significance level was set at p < 0.05.
resultsA total of 41 patients (25 male) with median (interquartile range (IQR)) age of 13 (10-15) years were included. Median (IQR) MRI PDFF was 11.30% (2.70-17.95%). Hepatic steatosis distribution by MRI PDFF included grade 0 (34%), grade 1 (15%), grade 2 (22%), and grade 3 (29%) patients. Intraclass correlation coefficient for HRI among the three readers was 0.61 (95% CI 0.43-0.75) (p < 0.001). Moderate correlation was observed between manually estimated HRI and PDFF for each reader (r = 0.62, 0.67, and 0.67; p < 0.001). Optimal HRI cutoff was found to be 1.99 to diagnose hepatic steatosis (sensitivity 89%, specificity 93%). Median (IQR) HRI for each MRI grade of hepatic steatosis (0-4) was as follows: 1.2 (1.1-1.5), 2.6 (1.1-3.3), 3.6 (2.6-5.4), 5.6 (2.6-10.9), respectively (p < 0.001).
conclusionUltrasound-estimated HRI has moderate interobserver agreement and moderate correlation with MRI-derived PDFF. HRI of 1.99 maximizes accuracy for identifying pediatric liver fat.
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