Ultrasound imaging has been widely applied to screen fatty liver disease. Fatty liver disease is a condition where large vacuoles of triglyceride fat accumulate in liver cells, thereby altering the arrangement of scatterers and the corresponding backscattered statistics. In this study, we used ultrasound Nakagami imaging to explore the effects of fatty infiltration in human livers on the statistical distribution of backscattered signals. A total of 107 patients volunteered to participate in the experiments. The livers were scanned using a clinical ultrasound scanner to obtain the raw backscattered signals for ultrasound B-mode and Nakagami imaging. Clinical scores of fatty liver disease for each patient were determined according to a well-accepted sonographic scoring system. The results showed that the Nakagami image can visualize the local backscattering properties of liver tissues. The Nakagami parameter increased from 0.62 ± 0.11 to 1.02 ± 0.07 as the fatty liver disease stage increased from normal to severe, indicating that the backscattered statistics vary from pre-Rayleigh to Rayleigh distributions. A significant positive correlation (correlation coefficient ρ = 0.84; probability value (p value) < 0.0001) exists between the degree of fatty infiltration and the Nakagami parameter, suggesting that ultrasound Nakagami imaging has potentials in future applications in fatty liver disease diagnosis.
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