{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T13:01:08Z","timestamp":1794574868017,"version":"4.9.1"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2011,8,1]],"date-time":"2011-08-01T00:00:00Z","timestamp":1312156800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["DK076852"],"award-info":[{"award-number":["DK076852"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["DK082451"],"award-info":[{"award-number":["DK082451"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2011,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Aims:<\/jats:title><jats:p>The diagnostic accuracy of hepatic ultrasonography (US) for detection and grading of hepatic steatosis in children with suspected nonalcoholic fatty liver disease (NAFLD) remains poorly characterized. The aim of this study was to prospectively evaluate the clinical utility of ultrasonographic quantification of hepatic steatosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods:<\/jats:title><jats:p>Our cohort consisted of 208 consecutive pediatric patients with biopsy\u2010proven NAFLD. Hepatic US was performed within 1 month of the liver biopsy procedure. Steatosis identified by US was scored using a 0 to 3 scale based on echogenicity and visualization of vasculature, parenchyma, and diaphragm, and compared to histological features based on Brunt's classification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>The median age at time of first visit was 10.8 years and 64% were boys. Sixty\u2010nine percent had moderate to severe steatosis on histology. Ultrasonographic steatosis score (USS) had an excellent correlation with histological grade of steatosis (with a Spearman's coefficient of 0.80). The area under the receiver operating characteristic curve for ultrasonographic detection of moderate\u2010to\u2010severe steatosis was 0.87. The USS did not correlate significantly with inflammatory activity or fibrosis stage; however, there was significant correlation with the NAFLD activity score (NAS), albeit this was in large part the result of the strong correlation with the steatosis component of NAS. Serum alanine transaminase and aspartate transaminase were not associated with histological grade of steatosis and showed no correlation with USS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>Our results, which represent the largest prospective pediatric study evaluating the role of hepatic US in children with biopsy\u2010proven NAFLD, demonstrate the utility of this technique for noninvasive diagnosis and estimation of hepatic steatosis in children.<\/jats:p><\/jats:sec>","DOI":"10.1097\/mpg.0b013e31821b4b61","type":"journal-article","created":{"date-parts":[[2011,7,23]],"date-time":"2011-07-23T00:11:40Z","timestamp":1311379900000},"page":"190-195","source":"Crossref","is-referenced-by-count":245,"title":["Ultrasonographic Quantitative Estimation of Hepatic Steatosis in Children With NAFLD"],"prefix":"10.1002","volume":"53","author":[{"given":"Angela","family":"Shannon","sequence":"first","affiliation":[{"name":"Department of Pediatric Gastroenterology Cleveland Clinic Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naim","family":"Alkhouri","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology Cleveland Clinic Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Carter\u2010Kent","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology Cleveland Clinic Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia","family":"Monti","sequence":"additional","affiliation":[{"name":"Liver Unit \u201cBambino Ges\u00f9\u201d Children's Hospital and Research Institute Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Devito","sequence":"additional","affiliation":[{"name":"Liver Unit \u201cBambino Ges\u00f9\u201d Children's Hospital and Research Institute Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocio","family":"Lopez","sequence":"additional","affiliation":[{"name":"Quantitative Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel E.","family":"Feldstein","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology Cleveland Clinic Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Nobili","sequence":"additional","affiliation":[{"name":"Liver Unit \u201cBambino Ges\u00f9\u201d Children's Hospital and Research Institute Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2008.171280"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20466"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2008.11.023"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.2174\/138161208786264197"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2009.09.001"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01526.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.35354"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2006.03161.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e31814b1d5b"},{"key":"e_1_2_8_11_1","first-page":"1","article-title":"CDC growth charts: United States","volume":"314","author":"Kuczmarski RJ","year":"2000","journal-title":"Adv Data"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7244.1240"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-1808"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2004.06.044"},{"key":"e_1_2_8_15_1","first-page":"525","article-title":"National Cholesterol Education Program: report of the expert panel on blood cholesterol levels in children and adolescents","volume":"89","author":"American Academy of Pediatrics.","year":"1992","journal-title":"Pediatrics"},{"key":"e_1_2_8_16_1","first-page":"1","article-title":"Task Force on Blood Pressure Control in Children. 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