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The HRI is a quantitative ultrasound parameter that compares the echogenicity of the liver to that of the right renal cortex and serves as a non-invasive tool for detecting and grading hepatic steatosis. It is particularly useful in routine abdominal ultrasound due to its simplicity, reproducibility, and applicability without the need for additional equipment. Normal HRI values typically range between 0.8 and 1.2, with values above 1.4\u20131.5 suggesting hepatic steatosis, and values exceeding 2.0 considered indicative of significant fatty infiltration. Several factors influence HRI accuracy, including image quality, region of interest (ROI) placement, and equipment settings. While software-assisted analysis can improve reproducibility, standardization across devices and protocols remains a challenge. Future developments should focus on consensus-based measurement techniques and the integration of artificial intelligence to enhance diagnostic precision and clinical applicability.<\/jats:p>","DOI":"10.1055\/a-2813-2022","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T22:32:27Z","timestamp":1779316347000},"page":"518-527","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound-Based Hepatorenal Index (HRI): Measurement Principles, Normal Values, and Clinical Application"],"prefix":"10.1055","volume":"64","author":[{"given":"Nils","family":"Daum","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t Zu Berlin, Germany","place":["Berlin"],"department":["Department of Anesthesiology and Intensive Care Medicine (CCM\/CVK)"]},{"name":"Medizinische Hochschule Brandenburg Theodor Fontane, BB, 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