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The aim of this study was to establish the diagnostic performance and comparison of a biological marker (SteatoTest) and an innovative imagistic parameter (the attenuation coefficient-AC) to identify hepatic steatosis and to assess its degree. Seventy seven patients with NAFLD morphologicaly proven by liver biopsy were prospectively studied, compared with 16 healthy subjects. The patients were stratify according to the degree of hepatic steatosis. The computerized processing of the data offered by ultrasonic image (AC) and a blood test (SteatoTest) were determined. The diagnostic value for each method was assessed using sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and the area under the receiving operating characteristics curve (AUROC). SteatoTest was found to differentiate between controls (0.173 ± 0.079) and NAFLD controls (0.744 ± 0.166) but failed to discriminate the degree of steatosis. AC had a good diagnostic value in detection of steatosis (controls (0.320 ± 0.502) and NAFLD (−0.122 ± 0.063) and could also discriminates between grades of steatosis. In conclusions our finding suggest that AC and Steat-Test could be used for detection of steatosis. A combination of these parameters might increase the diagnostic performance.