CEUS and Fibroscan in non-alcoholic fatty liver disease and non-alcoholic steatohepatitis

Cocciolillo, Sila; Parruti, Giustino; Marzio, L.

doi:10.4254/wjh.v6.i7.496

Cited by 24 publications

(13 citation statements)

References 23 publications

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“…Besides fibrosis, multivariate analysis in our study also showed that inflammation was another independent factor related to the liver elasticity of NAFLD rabbits ( B = 1.248, 95% CI 0.519-1.977, P ≤ 0.001). This was consistent with that reported in previous studies [27, 28] and may be related to the inflammatory cell infiltration and increased pressure in the liver. However, our finding was different from those reported by Lee et al [15] and Kang et al [17].…”

Section: Discussionsupporting

confidence: 94%

Can Nonfibrotic Nonalcoholic Steatohepatitis Be Effectively Identified by Supersonic Shear Imaging?

Yang

Liu

Xue

et al. 2019

Analytical Cellular Pathology

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Supersonic shear imaging (SSI) is a relatively new technique to measure the elasticity of target tissues based on the shear wave propagation. The aim of this study was to evaluate the value of SSI in discriminating nonfibrotic nonalcoholic steatohepatitis (NASH) from the less severe nonalcoholic fatty liver disease (NAFLD), NASH with fibrosis, and the normal liver, as well as the relationship between various NAFLD pathologic or biochemical findings and SSI liver elasticity. Rabbits with NAFLD of different degrees were subjected to SSI for liver elasticity measurement. Plasma was collected for biochemical examinations, and liver tissues were harvested for pathologic assessment. Results showed that liver elasticity of rabbits with nonfibrotic NASH was significantly different from that of rabbits with simple steatosis, borderline, NASH with fibrosis, and normal liver (P<0.05) and the areas under the receiver operating characteristic curve of SSI for predicting nonfibrotic NASH and NASH with fibrosis were 0.997 and 0.967, respectively, and the optimal cutoff values were 10.17 kPa and 12.82 kPa, respectively. Multivariate analysis showed that only fibrosis and inflammation were the independent factors affecting liver elasticity of NAFLD (P≤0.001), while inflammation, steatosis, and ballooning degeneration were all independently related to liver elasticity in rabbits without fibrosis (P<0.01). In addition, alanine aminotransferase was the only biochemical factor independently related to liver elasticity (P≤0.001). Our results indicate that SSI can effectively identify nonfibrotic NASH in rabbits based on the difference in liver elasticity and the difference is related to the various pathologic changes, including fibrosis, inflammation, steatosis, and ballooning degeneration.

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Section: Discussionsupporting

confidence: 94%

Can Nonfibrotic Nonalcoholic Steatohepatitis Be Effectively Identified by Supersonic Shear Imaging?

Yang

Liu

Xue

et al. 2019

Analytical Cellular Pathology

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“…Lastly, CEUS imaging is sensitive to fatty liver disease progression and can accurately detect vascular features of NASH 20 . It was shown that the CEUS-based PE and WIR parameters decreased in fatty livers and consistent with previous studies 20 , 23 . Fat accumulation in the liver parenchyma can produce microvascular constriction and blood flow resistance during the pathologic progression of NAFLD disease.…”

Section: Discussionsupporting

confidence: 92%

“…If unhindered, hepatic vein transit time and intrahepatic circulatory time progressively decrease with liver disease severity due in part to arteriovenous shunting and a hyperdynamic circulatory state (i.e., temporal kinetic changes in MB contrast agent flow) 21 , 22 . In the case of NASH, this progressive blood flow derangement within the liver precedes liver fibrosis development 23 and any of the eventual complications of cirrhosis, such as HCC and portal vein thrombus 22 . It is worth noting that fibrotic changes also increase the absolute peak of contrast enhancement during CEUS imaging since arteriovenous shunts reduce the rate of MB dissolution as the contrast agent bypasses capillary beds 24 .…”

Section: Introductionmentioning

confidence: 99%

Multiparametric ultrasound imaging for the assessment of normal versus steatotic livers

Basavarajappa

Baek

Reddy

et al. 2021

Sci Rep

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Liver disease is increasing in prevalence across the globe. We present here a multiparametric ultrasound (mpUS) imaging approach for assessing nonalcoholic fatty liver disease (NALFD). This study was performed using rats (N = 21) that were fed either a control or methionine and choline deficient (MCD) diet. A mpUS imaging approach that includes H-scan ultrasound (US), shear wave elastography, and contrast-enhanced US measurements were then performed at 0 (baseline), 2, and 6 weeks. Thereafter, animals were euthanized and livers excised for histological processing. A support vector machine (SVM) was used to find a decision plane that classifies normal and fatty liver conditions. In vivo mpUS results from control and MCD diet fed animals reveal that all mpUS measures were different at week 6 (P < 0.05). Principal component analysis (PCA) showed that the H-scan US data contributed the highest percentage to the classification among the mpUS measurements. The SVM resulted in 100% accuracy for classification of normal and high fat livers and 92% accuracy for classification of normal, low fat, and high fat livers. Histology findings found considerable steatosis in the MCD diet fed animals. This study suggests that mpUS examinations have the potential to provide a comprehensive estimation of the main components of early stage NAFLD.

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“…The result was similar to the previous studies on determining liver fat content by 1 H-MRS [21][22][23] . Most patients diagnosed with fatty liver have liver function damage and dyslipidemia.…”

Section: Correlation Analysis Between Metabolic Indices and Fat Contesupporting

confidence: 91%

Ultrasound hepatic/renal ratio and hepatic attenuation rate for quantifying liver fat content

Zhang

Ding

Chen

et al. 2014

WJG

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AIM:To establish and validate a simple quantitative assessment method for nonalcoholic fatty liver disease (NAFLD) based on a combination of the ultrasound hepatic/renal ratio and hepatic attenuation rate. METHODS:A total of 170 subjects were enrolled in this study. All subjects were examined by ultrasound and 1 H-magnetic resonance spectroscopy ( 1 H-MRS) on the same day. The ultrasound hepatic/renal echointensity ratio and ultrasound hepatic echo-intensity attenuation rate were obtained from ordinary ultrasound images using the MATLAB program. RESULTS:Correlation analysis revealed that the ultrasound hepatic/renal ratio and hepatic echo-intensity attenuation rate were significantly correlated with 1 H-MRS liver fat content (ultrasound hepatic/renal ratio: r = 0.952, P = 0.000; hepatic echo-intensity attenuation r = 0.850, P = 0.000). The equation for predicting liver fat content by ultrasound (quantitative ultrasound model) is: liver fat content (%) = 61.519 × ultrasound hepatic/renal ratio + 167.701 × hepatic echo-intensity attenuation rate -26.736. Spearman correlation analysis revealed that the liver fat content ratio of the quantitative ultrasound model was positively correlated with serum alanine aminotransferase, aspartate aminotransferase, and triglyceride, but negatively correlated with high density lipoprotein cholesterol. Receiver operating characteristic curve analysis revealed that the optimal point for diagnosing fatty liver was 9.15% in the quantitative ultrasound model. Furthermore, in the quantitative ultrasound model, fatty liver diagnostic sensitivity and specificity were 94.7% and 100.0%, respectively, showing that the quantitative ultrasound model was better than conventional ultrasound methods or the combined ultrasound hepatic/renal ratio and hepatic echo-intensity attenuation rate. If the 1 H-MRS liver fat content had a value < 15%, the sensitivity and specificity of the ultrasound quantitative model would be 81.4% and 100%, which still shows that using the model is better than the other methods. CONCLUSION:The quantitative ultrasound model is a simple, low-cost, and sensitive tool that can accurately assess hepatic fat content in clinical practice. It provides an easy and effective parameter for the early diagnosis of mild hepatic steatosis and evaluation of the efficacy of NAFLD treatment. Key words: Non-alcoholic fatty liver disease; Ultrasound hepatic/renal ratio; Ultrasound hepatic echo-intensity attenuation rateCore tip: The quantitative ultrasound model is a simple, low-cost, and sensitive tool that can accurately assess hepatic fat content in clinical practice. It provides an easy and effective parameter for early diagnosis of mild hepatic steatosis and evaluation of the efficacy of Zhang B, Ding F, Chen T, Xia LH, Qian J, Lv GY. Ultrasound hepatic/renal ratio and hepatic attenuation rate for quantifying liver fat content.

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CEUS and Fibroscan in non-alcoholic fatty liver disease and non-alcoholic steatohepatitis

Cited by 24 publications

References 23 publications

Can Nonfibrotic Nonalcoholic Steatohepatitis Be Effectively Identified by Supersonic Shear Imaging?

Can Nonfibrotic Nonalcoholic Steatohepatitis Be Effectively Identified by Supersonic Shear Imaging?

Multiparametric ultrasound imaging for the assessment of normal versus steatotic livers

Ultrasound hepatic/renal ratio and hepatic attenuation rate for quantifying liver fat content

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