{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:31:54Z","timestamp":1790404314524,"version":"4.1.0"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T00:00:00Z","timestamp":1628726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Purpose<\/jats:title><jats:p>To evaluate the reliability of ultrasound hepatorenal index (US-HRI) and magnetic resonance imaging proton density fat fraction (MRI-PDFF) techniques in the diagnosis of hepatic steatosis, with magnetic resonance spectroscopy proton density fat fraction (MRS-PDFF) as the reference standard.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Materials and methods<\/jats:title><jats:p>Fifty-two adult volunteers (30 men, 22 women; age, 31.5 \u00b1 6.5 years) who had no history of kidney disease or viral\/alcoholic hepatitis were recruited to undergo abdominal US, MRI, and MRS examinations. US-HRI was calculated from the average of three pairs of regions of interest (ROIs) measurements placed in the liver parenchyma and right renal cortex. On MRI, the six-point Dixon technique was employed for calculating proton density fat fraction (MRI-PDFF). An MRS sequence with a typical voxel size of 27 ml was chosen to estimate MRS-PDFF as the gold standard. The data were evaluated using Pearson\u2019s correlation coefficient and receiver operating characteristic (ROC) curves.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>The Pearson correlation coefficients of US-HRI and MRI-PDFF with MRS-PDFF were 0.38 (<jats:italic>p<\/jats:italic>= 0.005) and 0.95 (<jats:italic>p<\/jats:italic>&lt;0.001), respectively. If MRS-PDFF \u22655.56% was defined as the gold standard of fatty liver disease, the areas under the curve (AUCs), cut-off values, sensitivities and specificities of US-HRI and MRI-PDFF were 0.74, 1.54, 50%, 91.7% and 0.99, 2.75%, 100%, 88.9%, respectively. The intraclass correlation coefficients (ICCs) of US-HRI and MRI-PDFF were 0.70 and 0.85.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusion<\/jats:title><jats:p>MRI-PDFF was more reliable than US-HRI in diagnosing hepatic steatosis.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0255768","type":"journal-article","created":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T19:13:36Z","timestamp":1628795616000},"page":"e0255768","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":19,"title":["Reliability of ultrasound hepatorenal index and magnetic resonance imaging proton density fat fraction techniques in the diagnosis of hepatic steatosis, with magnetic resonance spectroscopy as the reference standard"],"prefix":"10.1371","volume":"16","author":[{"given":"Bien Van","family":"Tran","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kouichi","family":"Ujita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7046-9355","authenticated-orcid":true,"given":"Ayako","family":"Taketomi-Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromi","family":"Hirasawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Suto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshito","family":"Tsushima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,8,12]]},"reference":[{"key":"pone.0255768.ref001","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1016\/j.jhep.2018.05.036","article-title":"Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016\u20132030","volume":"69","author":"C Estes","year":"2018","journal-title":"J Hepatol"},{"key":"pone.0255768.ref002","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1002\/hep.28431","article-title":"Global epidemiology of nonalcoholic liver disease\u2014Meta-analytic assessment of prevalence, incidence, and outcomes","volume":"64","author":"ZM Younossi","year":"2016","journal-title":"Hepatology"},{"key":"pone.0255768.ref003","doi-asserted-by":"crossref","first-page":"3415","DOI":"10.3390\/ijerph16183415","article-title":"NAFLD and extra-hepatic comorbidities: Current evidence on a multi-organ metabolic syndrome","volume":"16","author":"V Rosato","year":"2019","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0255768.ref004","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/j.jid.2017.10.024","article-title":"Risk of incident liver disease in patients with psoriasis, psoriatic arthritis, and rheumatoid arthritis: A population-based study","volume":"138","author":"A Ogdie","year":"2018","journal-title":"J Invest Dermatol"},{"key":"pone.0255768.ref005","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1159\/000282080","article-title":"Epidemiology of non-alcoholic fatty","volume":"28","author":"S Bellentani","year":"2010","journal-title":"Dig Dis"},{"key":"pone.0255768.ref006","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1053\/j.gastro.2015.04.005","article-title":"Weight loss through lifestyle modification significantly reduces features of nonalcoholic steatohepatitis","volume":"149","author":"E Vilar-Gomez","year":"2015","journal-title":"Gastroenterology"},{"key":"pone.0255768.ref007","doi-asserted-by":"crossref","first-page":"475","DOI":"10.3748\/wjg.v20.i2.475","article-title":"Limitations of liver biopsy and non-invasive diagnostic tests for the diagnosis of nonalcoholic fatty liver disease\/ nonalcoholic steatohepatitis","volume":"20","author":"Y Sumida","year":"2014","journal-title":"World J Gastroenterol"},{"key":"pone.0255768.ref008","first-page":"88","article-title":"Sonographic quantification of a hepato-renal index for the assessment of hepatic steatosis in comparison with 3T proton magnetic resonance spectroscopy. 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