Grade 1 (mild) is represented by a diffuse slight increase in fine echoes in the hepatic parenchyma with normal visualisation of the diaphragm and intrahepatic vessel borders.
The density of this capillary formation is illustrated in D, where endothelial cells, indicating vessel borders, lie nearly wall to wall.
Grade 3 (marked) is represented by a marked increase in fine echoes with poor or no visualisation of the intrahepatic vessel borders, diaphragm and posterior portion of the right lobe of the liver [15].
Although the vessel borders were difficult to define by CNA35 staining alone, MTP was able to clearly stain myocytes and thickened arterial wall, offering a useful counterstain (Figure 3C).
Vessel borders could be easily identified and blurred edges constituted no major obstacle due to viable resolution.
Finally, positioning the cursors at the vessel borders is known to be difficult and has been the main reason why alternative techniques have been suggested [ 10, 11].
The diagnostic criteria were: (i) Absence: normal echogenicity and (ii) Presence: alteration of the fine echoes, visualization of diaphragm and intra hepatic vessel borders according to Saadeh et al [ 17].
Hepatic steatosis was diagnosed on the basis of characteristic sonographic features, i.e., evidence of diffuse hyperechogenicity of the liver relative to the kidneys, ultrasound beam attenuation, and poor visualization of intrahepatic vessel borders and diaphragm (28).
However, any caliper measurement of a vessel stenosis in vivo relies on a number of subjective factors, such as precise position of the calipers at the vessel borders as well as the decision where to measure the most stenotic segment and where to locate the reference segment.
The results become less surprising, however, when one examines the way caliper measurements are performed: first, the reference region and the region of the maximum stenosis have to be identified visually, then the precise position of the calipers at the vessel borders has to be identified.
