Fig. 2

Quantification of echo intensity. Principle of the sonographic hepatorenal index. ROIs are placed over the liver parenchyma and renal cortex at the same depth. Mean echo intensities are determined on a standard 8-bit US image, e.g. in this example with freeware ImageJ, National Institutes of Health, Bethesda, MD, USA). SHRI is calculated by dividing the mean liver brightness by the mean renal cortex brightness. In this example 59/14 = 4.21, i.e. severely fatty [20–23]