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Objectives: Steatosis, nonalcoholic steatohepatitis (NASH), and fibrosis/cirrhosis represent a spectrum of fatty liver disease. The ultrasound fatty liver indicator (US‐FLI) evaluates ultrasound (US) features to identify stages of fatty liver disease. We hypothesized that US features could be independent predictors of NASH and that the US‐FLI differentiates steatosis from NASH in the average obese population. Methods: A retrospective analysis of 208 patients with normal (n = 14), steatotic (n = 89), and NASH (n = 105) livers was performed. Liver/biliary disease and a history of alcohol intake were excluded. Ultrasound metrics included liver‐kidney contrast, posterior attenuation, vessel blurring, difficulty visualizing the gallbladder wall, difficulty visualizing the diaphragm, and areas of focal fatty sparing. A statistical comparison of the 3 groups as well as fibrosis stage I and II/III NASH groups was performed. Logistic regression identified independent predictors of NASH. Results: Gallbladder wall visualization and vessel blurring were different between the steatosis and NASH groups (P ≤.01). Gallbladder wall visualization was specific for NASH (89%), and vessel blurring was sensitive for NASH (93%). A US‐FLI score of 4 or lower suggested the absence of NASH (negative predictive value, 88%; sensitivity, 91%). Logistic regression revealed vessel blurring as the only US predictor of NASH (P ≤.01). However, the area under the curve (0.649) showed poor performance in differentiating steatosis from NASH when the US‐FLI score was 5 or higher. Conclusions: Our data suggest that the US‐FLI may differentiate steatosis from NASH in the average obese population. Vessel blurring and poor gallbladder wall visualization were the most important metrics. Identification of NASH was enhanced by including the US‐FLI score with vessel blurring. [ABSTRACT FROM AUTHOR]

Acute pulmonary embolism (PE) is a common, and sometimes fatal, diagnosis that results in over 11,000 deaths in hospitalized patients in the USA annually. In patients with high-risk or high-intermediate-risk PE and especially in whom thrombolytic therapy is contraindicated, mechanical thrombectomy can be an effective treatment option. This case series outlines three patients with PE who were successfully treated with large bore aspiration thrombectomy by Interventional Radiology at a community-based military treatment facility (MTF). Two patients had presented to the emergency department with acute PE and a third of patients with acute PE were transferred from an outside hospital specifically for mechanical thrombectomy due to a complication from systemic anticoagulation. The patients were categorized as good candidates for immediate large-bore aspiration thrombectomy, a recently added capability at the MTF. The patients showed immediate improvement post-procedure and required only one night admission for observation to the intensive care unit. Implementation of this new capability for patients with acute high-risk or high-intermediate-risk PE or with contraindications to thrombolysis provides an alternative treatment with immediate, life-saving capability. [ABSTRACT FROM AUTHOR]