The Hyperdense Right Hemidiaphragm Sign: A Novel Radiological Indicator of Diffuse Fatty Liver Infiltration on Non-Enhanced CT.

Objectives The primary objective of this study is to describe and evaluate the diagnostic performance of the hyperdense right hemidiaphragm sign (HRHS) as a novel radiological indicator for diffuse fatty infiltration of the liver on non-enhanced CT (NECT) scans. This includes assessing its sensitivity, specificity, positive predictive value, and negative predictive value, and comparing these metrics with other established NECT signs. Methods This cross-sectional multicenter retrospective study included all patients over 12 years of age who underwent both abdominal MRI and NECT scans of the abdomen within a period not exceeding six months at two tertiary hospitals (The Royal Hospital and Armed Forces Hospital, Muscat, Sultanate of Oman) between January 2010 and December 2022.