Purpose:
The study aims to assess whether: 1) shear wave elastography (2D-SWE) and attenuation imaging (ATI) can confirm or dispute ultrasonographic (USG) diagnosis of liver steatosis, 2) there is a correlation between 2D-SWE and ATI results, and 3) which blood tests and liver condition indices are most related to a higher F index among participants.

Material and methods:
A group of 117 participants (hepatitis B and hepatitis C negative) with B-mode USG-diagnosed fatty liver was examined using ATI and 2D-SWE. Blood tests were performed, and data were analysed for normality, model fitting, and the identification of predictors for a higher F index. The likelihood ratio test assessed variables and their odds ratio in relation to the fibrosis-4 index (FIB-4), followed by interaction analysis with reference patients.

Results:
ATI and 2D-SWE provided more accurate liver diagnostics than USG. F2-F3 stages correlated with older age, higher glucose, aspartate aminotransferase (AST), FIB-4, De Ritis, AST to platelet ratio index (APRI), and gamma-glutamyl transpeptidase (GGTP). The model showed that AST was a strong indicator of higher F index. Univariate analysis revealed that higher odds for F2-F3 stages were associated with elevated glucose, FIB-4, De Ritis, ATI, AST, and APRI. Compared to S0, values greater than S1 were linked to a higher F index. Interaction analysis showed that only FIB-4-GGTP was significant, with higher GGTP reducing the impact of FIB-4.

Conclusions:
ATI and 2D-SWE may complement USG in assessing liver condition. Key predictors for a higher F index include S index, AST, glucose, De Ritis, and FIB-4, with APRI being moderately relevant.