Ultrasound attenuation coefficient of the liver and spleen in adults: A preliminary observation

  • Jing Gao
    Director of Ultrasound, Rocky Vista University, 255 E. Center Street, Ivins, UT 84738, USA.
    Rocky Vista University, Ivins, UT, USA
    Weill Cornell Medicine, Cornell University, New York, NY, USA
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Published:February 17, 2022DOI:


      • List attenuation coefficient of the spleen in adults with NAFLD
      • List the attenuation coefficient ratio of the liver to spleen in NAFLD
      • Report high correlation of liver ultrasound attenuation coefficient to MRI-PDFF



      The aim of the study was to assess ultrasound attenuation coefficient (AC) in adult liver and spleen.


      After obtaining IRB approval and written informed consent, liver AC and spleen AC were measured, and AC liver to spleen ratio (AC L/S = AC liver/AC spleen) was calculated in 36 adult volunteers (16 men and 20 women, mean age 50y). Based on magnetic resonance imaging derived proton density fat fraction (MRI-PDFF), the participants were divided into normal liver (MRI-PDFF <5%) and steatotic liver (MRI-PDFF ≥5%) groups. Difference in AC between the liver and spleen in each group and differences in liver AC and AC L/S between the two groups were analyzed using two-tailed t-test. Diagnostic performance of liver AC and AC L/S for determining hepatic steatosis was tested by area under receiver operating characteristic curve (AUROC).


      There were 12 normal livers and 24 steatotic livers in the study. The difference in AC between liver and spleen was significant in steatotic liver group (p < 0.001) whereas it was not in normal liver group (p > 0.05). Differences in liver AC and AC L/S between the two groups were significant (p < 0.001) whereas difference in spleen AC was not (p > 0.05). AUROC of liver AC and AC L/S for determining ≥ mild hepatic steatosis was 0.90 and 0.97, respectively.


      Liver AC increased, and spleen AC did not change following the development of hepatic steatosis. The feasibility of AC L/S in determining hepatic steatosis needs further investigation.


      AC (attenuation coefficient), AC L/S (attenuation coefficient liver to spleen ratio), ATI (attenuation imaging), AUROC (area under receiver operating characteristic curve), CT (computed tomography), LS (liver stiffness), MRE (magnetic resonance elastography), MRI-PDFF (magnetic resonance imaging-proton density fat fraction), NAFLD (nonalcoholic fatty liver disease)


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