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Clinical value of liver ultrasound for the diagnosis of nonalcoholic fatty liver disease in overweight and obese patients.

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  • معلومة اضافية
    • المصدر:
      Publisher: Wiley-Blackwell Country of Publication: United States NLM ID: 101160857 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1478-3231 (Electronic) Linking ISSN: 14783223 NLM ISO Abbreviation: Liver Int Subsets: MEDLINE
    • بيانات النشر:
      Publication: Malden, MA : Wiley-Blackwell
      Original Publication: Oxford, UK : Blackwell Munksgaard, c2003-
    • الموضوع:
      Diabetes Mellitus, Type 2/*complications ; Liver/*diagnostic imaging ; Non-alcoholic Fatty Liver Disease/*diagnosis ; Obesity/*complications ; Overweight/*complications; Biopsy ; Female ; Humans ; Liver/pathology ; Magnetic Resonance Spectroscopy ; Male ; Middle Aged ; ROC Curve ; Severity of Illness Index ; Ultrasonography
    • نبذة مختصرة :
      Background & Aims: Liver ultrasound (US) is usually used in the clinical setting for the diagnosis and follow-up of patients with nonalcoholic fatty liver disease (NAFLD). However, no large study has carefully assessed its performance using a semiquantitative ultrasonographic scoring system in overweight/obese patients, in comparison to magnetic resonance spectroscopy ((1) H-MRS) and histology.
      Methods: We recruited 146 patients and performed: a liver US using a 5-parameter scoring system, a liver (1) H-MRS to quantify liver fat content, and a liver biopsy to assess histology. All measurements were repeated in a subgroup of patients (n = 62) after 18 months of follow-up.
      Results: The performance of liver US (parenchymal echo alone) was rather modest, and significantly worse than (1) H-MRS (AUROC: 0.82 [0.69-0.94] vs. 0.96 [0.90-1.00]; P = 0.04). However, the AUROC improved when different echographic parameters were taken into account (AUROC: 0.89 [0.83-0.96], P = 0.15 against (1) H-MRS). Optimum sensitivity for liver US was achieved at a liver fat content ≥12.5%, suggesting that below this threshold, liver US is less sensitive. Liver (1) H-MRS showed a high accuracy for the diagnosis of NAFLD, and correlated strongly with histological steatosis (r = 0.73, P < 0.0001). None of the imaging tests was adequate enough to predict changes over time in histology.
      Conclusions: Despite its widespread use, liver US has several important limitations that healthcare providers should recognize, particularly because of its low sensitivity. Using a combination of echographic parameters, liver US showed a significant improvement in its diagnostic performance, but still was of limited value for monitoring treatment over time.
      (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
    • Comments:
      Comment in: Liver Int. 2015 Oct;35(10):2340-1. doi: 10.1111/liv.12854. (PMID: 25913160)
      Comment in: Liver Int. 2015 Oct;35(10):2341-2. doi: 10.1111/liv.12869. (PMID: 25964992)
    • Contributed Indexing:
      Keywords: NAFLD; NASH; Obesity; hepatic steatosis; steatohepatitis
    • الموضوع:
      Date Created: 20150408 Date Completed: 20160505 Latest Revision: 20220321
    • الموضوع:
      20250114
    • الرقم المعرف:
      10.1111/liv.12840
    • الرقم المعرف:
      25847730