The Accuracy of Sonography in Predicting Steatosis and Fibrosis in Chronic Hepatitis C

Chen, Chien‐Hua; Lin, Shang-Tao; Yang, Chi‐Chieh; Yeh, Yung‐Hsiang; Kuo, Chien-Long; Nien, Chiu-Kue

doi:10.1007/s10620-007-0048-2

Cited by 35 publications

(17 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…66 Although several specific features have been identified to be unique to NAFLD when using ultrasound, and the inter-observer agreement for identifying these features has been shown to be relatively good, the sensitivity of these findings is considerably lower when the overall content of hepatic steatosis is < 20%. 67–75 Furthermore, patient demographics (obesity) and co-existing conditions (hepatitis C) have been shown to further reduce the sensitivity of this diagnostic tool, 75–79 which significantly impacts its ability to reliability distinguish between the presence or absence of hepatic steatosis among at-risk individuals.…”

Section: Mri-based Assessment Of Hepatic Steatosismentioning

confidence: 99%

MRI and MRE for non-invasive quantitative assessment of hepatic steatosis and fibrosis in NAFLD and NASH: Clinical trials to clinical practice

Dulai

Sirlin

Loomba

2016

Journal of Hepatology

294

262

View full text Add to dashboard Cite

Nonalcoholic fatty liver disease (NAFLD) represents one of the most common causes of chronic liver disease, and its prevalence is rising worldwide. The occurrence of nonalcoholic steatohepatitis (NASH) is associated with a substantial increase in disease related morbidity and mortality. Accordingly, there has been a surge of innovation surrounding drug development in an effort to off-set the natural progression and long-term risks of this disease. Disease assessment within clinical trials and clinical practice for NAFLD is currently done with liver biopsies. Liver biopsy-based assessments, however, remain imprecise and are not without cost or risk. This carries significant implications for the feasibility and costs of bringing therapeutic interventions to market. A need therefore arises for reliable and highly accurate surrogate end-points that can be used in phase 2 and 3 clinical trials to reduce trial size requirements and costs, while improving feasibility and ease of implementation in clinical practice. Significant advances have now been made in magnetic resonance technology, and magnetic resonance imaging (MRI) and elastrography (MRE) have been demonstrated to be highly accurate diagnostic tools for the detection of hepatic steatosis and fibrosis. In this review article, we will summarize the currently available evidence regarding the use of MRI and MRE among NAFLD patients, and the evolving role these surrogate biomarkers will play in the rapidly advancing arena of clinical trials in NASH and hepatic fibrosis. Furthermore, we will highlight how these tools can be readily applied to routine clinical practice, where the growing burden of NAFLD will need to be met with enhanced monitoring algorithms.

show abstract

Section: Mri-based Assessment Of Hepatic Steatosismentioning

confidence: 99%

MRI and MRE for non-invasive quantitative assessment of hepatic steatosis and fibrosis in NAFLD and NASH: Clinical trials to clinical practice

Dulai

Sirlin

Loomba

2016

Journal of Hepatology

294

262

View full text Add to dashboard Cite

show abstract

“…Nevertheless, the ability of ultrasound to evaluate the presence and degree of LS remains debatable. In fact, although some authors have shown that the bright liver echo pattern (BLP) is strongly correlated with the diagnosis of hepatic steatosis [6][7][8][9][10][11][12][13], other authors think that this pattern is non-specific because the liver echogenicity on ultrasonography also increases with liver fibrosis [14][15][16][17][18][19][20]. Recently, the simultaneous presence of BLP, posterior attenuation, and/or areas with different patterns of fat infiltration (so-called skip areas) around gallbladder or near the portal vein [21] have been identified as distinctive signs of steatosis involving a number of hepatocytes in a microscopic field [30 % [11].…”

Section: Introductionmentioning

confidence: 99%

The prevalence of bright liver echo pattern in patients with chronic hepatitis C: correlation with steatosis and fibrosis

Loy¹,

Serra

Chessa

2014

J Ultrasound

View full text Add to dashboard Cite

Purpose To evaluate the prevalence of bright liver echo pattern (BLP) on ultrasonography and its correlation with liver steatosis (LS), and fibrosis in patients with chronic hepatitis C. The usefulness of detecting skip areas for steatosis diagnosis has also been evaluated. Methods The study included 88 patients with chronic hepatitis C (55 men, 33 women, average age 45.7 ± 11.2 years). Ultrasound examination was performed in all patients before liver biopsy. The presence of BLP was assessed and graded from 1 to 3. Hypoechogenic areas (skip areas) around the gallbladder or near the portal vein were also evaluated. Hepatic fibrosis was assessed using the Ishak fibrosis score. Steatosis was graded as follows: 1, 2, 3 (\30, 30-70, [70 % of hepatocytes affected, respectively). Results Fifty-three of the 88 patients (60 %) showed BLP (40 grade 1, 13 grades 2 or 3). Skip areas were found in 14 patients (16 %). Histological steatosis was observed in 40 patients (45 %) and in 10 of them (25 %) was grades 2 and 3 (4 and 6 patients, respectively). As regards fibrosis, 2 patients showed F0, 34 F1, 28 F2, 20 F3, 4 F4, none of them F5 and F6. BLP of grades 2 or 3 and presence of skip areas were strongly correlated with LS (P = 0.00007 and P = 0.00003, respectively). No correlation was found between BLP and fibrosis. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of BLP for LS were 75, 50, 56, 68 and 61 %, respectively. When BLP of grades 2 and 3 and LS of 30 % or more were correlated, the sensitivity, specificity, PPV, NPV and accuracy of BLP were 72, 96, 61, 96 and 90 %, respectively. As regards skip areas the sensitivity, specificity, PPV, NPV and accuracy for LS were 35, 100, 100, 64 and 70 %, respectively. Conclusions In a well-defined group of patients with chronic hepatitis C, the detection of BLP grades 2 and 3 has a good sensitivity and high specificity for high grades of steatosis. A high specificity but low sensitivity for liver steatosis was also found for skip areas, whereas mild fibrosis does not seem to correlate with the hyperechogenicity of the liver.Keywords Liver steatosis Á Ultrasonography Á Bright liver echo pattern Á Skip areas Á Chronic hepatitis C Riassunto Scopo Scopo del lavoro é stato quello di valutare la prevalenza del ''bright liver echo pattern'' (BLP) all'ultrasonografia e la sua correlazione con la steatosi epatica (SE) e la fibrosi in un gruppo di pazienti con epatite cronica C. E' stata valutata anche l'utilità della determinazione delle cosiddette ''aree di risparmio'' per la diagnosi di steatosi. Metodi Lo studio ha incluso 88 pazienti con epatite cronica C (55 di sesso maschile, 33 di sesso femminile; età media 45.7 ± 11.2 anni). L'esame ultrasonografico é stato eseguito in tutti i pazienti prima di effettuare la biopsia epatica. La presenza di BLP é stata graduata da 1 a 3. É stata anche valutata la presenza o meno di aree ipoecogene (cosiddette ''aree di risparmio''), adiacenti alla colecisti o in sede parailare epatic...

show abstract

“…These drawbacks limit the use of ultrasound in longitudinal studies. To date, grayscale B-mode ultrasound is not considered a replacement for liver biopsy in evaluating fatty liver [18].…”

Section: Introductionmentioning

confidence: 99%

Relationship between Ultrasound Backscattered Statistics and the Concentration of Fatty Droplets in Livers: An Animal Study

Lee

Jeng

et al. 2013

PLoS ONE

View full text Add to dashboard Cite

Ultrasound grayscale B-mode imaging is the most frequently used modality for examining fatty liver. Different concentrations and arrangements of fatty droplets in the liver may produce different statistical distributions of ultrasound backscatter signals, which may be treated as a useful clue for assessing the stage of fatty liver. To verify this point, we investigate the relationship between changes in backscattered statistics and the concentration of fatty droplets in the liver. Fatty liver was induced in rats fed a methionine-choline-deficient diet. Livers were excised from rats for in vitro ultrasound scanning using a single-element transducer. The envelopes of the acquired raw ultrasound signals were used for the analysis of the backscattered statistics by ultrasound Nakagami parametric imaging, which has been shown as a reliable tool to model the statistical distribution of ultrasound backscatter signals. Histological analyses and the measurements of triglyceride and cholesterol in the rat liver were conducted for comparison with the Nakagami parameter. Results show that the ultrasound Nakagami parameter has an excellent correlation with the concentration of fatty droplets, demonstrating that ultrasound backscatter statistics depend on the degree of fatty liver in rats.

show abstract

The Accuracy of Sonography in Predicting Steatosis and Fibrosis in Chronic Hepatitis C

Cited by 35 publications

References 30 publications

MRI and MRE for non-invasive quantitative assessment of hepatic steatosis and fibrosis in NAFLD and NASH: Clinical trials to clinical practice

MRI and MRE for non-invasive quantitative assessment of hepatic steatosis and fibrosis in NAFLD and NASH: Clinical trials to clinical practice

The prevalence of bright liver echo pattern in patients with chronic hepatitis C: correlation with steatosis and fibrosis

Relationship between Ultrasound Backscattered Statistics and the Concentration of Fatty Droplets in Livers: An Animal Study

Contact Info

Product

Resources

About