How Good Is Trans Abdominal Ultrasound for Evaluating NAFLD in the General Population? A Cross-Sectional Study
Abstract
Nonalcoholic fatty liver disease (NAFLD) is one of the most common cause of liver test abnormality and chronic liver disease in the world and can increase liver related mortality. Association of NAFLD with metabolic syndrome increase mortality due to cardiovascular disease too. NAFLD is categorized histologically into the nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). Liver biopsy has been known as gold standard of evaluating NAFLD, but this procedure is invasive. It is time to replace available and easier way to diagnose, and predict the prognosis for better management of NAFLD. This study was comparing the result of transabdominal ultrasonography with Fibroscan as a new and accurate method for evaluating severity of fatty liver disease. This was a cross-sectional study that was conducted using 101 patients with NAFLD. All patients who had TUS by one experienced radiologist and fibro scan at the same time were included. Visual liver echogenicity was basis of grading in TUS. Fibro scans results are based on controlled attenuation parameters (CAP) which is not operator dependent. Other information, such as age, waist, and BMI, were also gathered. TUS has a low value for the diagnosis of liver fibrosis in NAFLD patients and predicting prognosis. TUS has a good correlation with fibroscan in grade 0 and 1of fatty liver, but in grade 2 and 3 of fatty liver, we can not rely on TUS for accurate grading.
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2. Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, et al. The diagnosis and management of non‐alcoholic fatty liver disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012; 55(6):2005-23.
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8-Vlad Ratziu, Frederic Charlotte, Agnes Heurtier, Sophie Gombert, Pillippe Giral , Eric Bruckert, Andre Grimaldi , Frederique Capron , and Thierry Poynard for the LIDO Study Group . Sampling Variability of Liver Biopsy in Nonalcoholic Fatty Liver Disease . Gastroenterology 2005;128:1898–1906
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10. Cassinotto C, Boursier J, de Lédinghen V, Lebigot J, Lapuyade B, Cales P, et al. Liver stiffness in nonalcoholic fatty liver disease: a comparison of supersonic shear imaging, FibroScan, and ARFI with liver biopsy. Hepatology. 2016.
11. Petta S, Maida M, Macaluso FS, Di Marco V, Cammà C, Cabibi D, et al. The severity of steatosis influences liver stiffness measurement in patients with nonalcoholic fatty liver disease. Hepatology. 2015; 62(4):1101-10.
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13. Al-Ghamdi AS. Fibroscan®: A noninvasive test of liver fibrosis assessment. Saudi Journal of Gastroenterology. 2007; 13(3):147.
14. Sandrin L, Fourquet B, Hasquenoph J-M, Yon S, Fournier C, Mal F, et al. Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound in medicine & biology. 2003; 29(12):1705-13.
15. Yoneda M, Mawatari H, Fujita K, Endo H, Iida H, Nozaki Y, et al. Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with nonalcoholic fatty liver disease (NAFLD). Digestive and Liver Disease. 2008; 40(5):371-8.
16. Nobili V, Vizzutti F, Arena U, Abraldes JG, Marra F, Pietrobattista A, et al. Accuracy and reproducibility of transient elastography for the diagnosis of fibrosis in pediatric nonalcoholic steatohepatitis. Hepatology. 2008; 48(2):442-8.
17. Wong VWS, Vergniol J, Wong GLH, Foucher J, Chan HLY, Le Bail B, et al. Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease. Hepatology. 2010; 51(2):454-62.
18. Lupsor M, Badea R, Stefanescu H, Grigorescu M, Serban A, Radu C, et al. Performance of unidimensional transient elastography in staging non-alcoholic steatohepatitis. J Gastrointestin Liver Dis. 2010; 19(1):53-60.
19. Petta S, Di Marco V, Cammà C, Butera G, Cabibi D, Craxi A. Reliability of liver stiffness measurement in non‐alcoholic fatty liver disease: the effects of body mass index. Alimentary pharmacology & therapeutics. 2011; 33(12):1350-60.
20. Mahadeva S, Mahfudz AS, Vijayanathan A, Goh KL, Kulenthran A, Cheah PL. Performance of transient elastography (TE) and factors associated with discordance in non‐alcoholic fatty liver disease. Journal of digestive diseases. 2013; 14(11):604-10.
21. Wong VW-S, Vergniol J, Wong GL-H, Foucher J, Chan AW-H, Chermak F, et al. Liver stiffness measurement using XL probe in patients with nonalcoholic fatty liver disease. The American journal of gastroenterology. 2012; 107(12):1862-71.
22. Myers RP, Pomier‐Layrargues G, Kirsch R, Pollett A, Duarte‐Rojo A, Wong D, et al. Feasibility and diagnostic performance of the FibroScan XL probe for liver stiffness measurement in overweight and obese patients. Hepatology. 2012; 55(1):199-208.
23. Patel K, Wilder J. Fibroscan. Clinical Liver Disease. 2014; 4(5):97-101.
24. Ballestri S, Lonardo A, Romagnoli D, Carulli L, Losi L, Day CP, et al. Ultrasonographic fatty liver indicator, a novel score which rules out NASH and is correlated with metabolic parameters in NAFLD. Liver International. 2012; 32(8):1242-52.
25. Dasarathy S, Dasarathy J, Khiyami A, Joseph R, Lopez R, McCullough AJ. Validity of real time ultrasound in the diagnosis of hepatic steatosis: a prospective study. Journal of hepatology. 2009; 51(6):1061-7.
26. Schwenzer NF, Springer F, Schraml C, Stefan N, Machann J, Schick F. Non-invasive assessment and quantification of liver steatosis by ultrasound, computed tomography and magnetic resonance. Journal of hepatology. 2009; 51(3):433-45.
27. Tobari M, Hashimoto E, Yatsuji S, Torii N, Shiratori K. Imaging of nonalcoholic steatohepatitis: advantages and pitfalls of ultrasonography and computed tomography. Internal Medicine. 2009; 48(10):739-46.
28. Dasarathy S, Dasarathy J, Khiyami A, Joseph R, Lopez R, McCullough AJ. Validity of real time ultrasound in the diagnosis of hepatic steatosis: a prospective study. Journal of hepatology. 2009; 51(6):1061-7.
29. Saadeh S, Younossi ZM, Remer EM, Gramlich T, Ong JP, Hurley M, et al. The utility of radiological imaging in nonalcoholic fatty liver disease. Gastroenterology. 2002; 123(3):745-50.
30. Hannah WN, Harrison SA. Noninvasive imaging methods to determine severity of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. Hepatology. 2016; 64(6):2234-
2. Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, et al. The diagnosis and management of non‐alcoholic fatty liver disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012; 55(6):2005-23.
3.Zobair M Younossi, Aaron B Koenig , Dinan Abdelatif, Yousef Fazel, Linda Henry, Mark Wymer. Global epidemiology of nan alchoholic fatty liver disease – Mata analytic assessment of prevalence , incidence ,and outcome . Hepatology volum 64,issue 12016 73-84
4. Lankarani KB, Ghaffarpasand F, Mahmoodi M, Lotfi M, Zamiri N, Heydari ST, et al. Nonalcoholic fatty liver disease in southern Iran: a population based study. Hepatitis monthly. 2013; 13(5).
5. Sotoudehmanesh R, Sotoudeh M, Ali-Asgari A, Abedi-Ardakani B, Tavangar S-M, Khakinejad A, et al. Silent liver diseases in autopsies from forensic medicine of Tehran. Arch Iran Med. 2006; 9(4):324-8.
6. Ratziu V, Charlotte F, Heurtier A, Gombert S, Giral P, Bruckert E, et al. Sampling variability of liver biopsy in nonalcoholic fatty liver disease. Gastroenterology. 2005; 128(7):1898-906.
7. Bohte AE, van Werven JR, Bipat S, Stoker J. The diagnostic accuracy of US, CT, MRI and 1H-MRS for the evaluation of hepatic steatosis compared with liver biopsy: a meta-analysis. European radiology. 2011; 21(1):87-97.
8-Vlad Ratziu, Frederic Charlotte, Agnes Heurtier, Sophie Gombert, Pillippe Giral , Eric Bruckert, Andre Grimaldi , Frederique Capron , and Thierry Poynard for the LIDO Study Group . Sampling Variability of Liver Biopsy in Nonalcoholic Fatty Liver Disease . Gastroenterology 2005;128:1898–1906
9. Cengiz M, Sentürk S, Cetin B, Bayrak AH, Bilek SU. Sonographic assessment of fatty liver: intraobserver and interobserver variability. International journal of clinical and experimental medicine. 2014; 7(12):5453.
10. Cassinotto C, Boursier J, de Lédinghen V, Lebigot J, Lapuyade B, Cales P, et al. Liver stiffness in nonalcoholic fatty liver disease: a comparison of supersonic shear imaging, FibroScan, and ARFI with liver biopsy. Hepatology. 2016.
11. Petta S, Maida M, Macaluso FS, Di Marco V, Cammà C, Cabibi D, et al. The severity of steatosis influences liver stiffness measurement in patients with nonalcoholic fatty liver disease. Hepatology. 2015; 62(4):1101-10.
12. Carvalhana S, Leita~o J, C. Alves A, Bourbon M, Cortez-Pinto H. How good is controlled attenuation parameter and fatty liver index for assessing liver steatosis in general population: correlation with ultrasound Liver International .ISSN 1478-3223.
13. Al-Ghamdi AS. Fibroscan®: A noninvasive test of liver fibrosis assessment. Saudi Journal of Gastroenterology. 2007; 13(3):147.
14. Sandrin L, Fourquet B, Hasquenoph J-M, Yon S, Fournier C, Mal F, et al. Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound in medicine & biology. 2003; 29(12):1705-13.
15. Yoneda M, Mawatari H, Fujita K, Endo H, Iida H, Nozaki Y, et al. Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with nonalcoholic fatty liver disease (NAFLD). Digestive and Liver Disease. 2008; 40(5):371-8.
16. Nobili V, Vizzutti F, Arena U, Abraldes JG, Marra F, Pietrobattista A, et al. Accuracy and reproducibility of transient elastography for the diagnosis of fibrosis in pediatric nonalcoholic steatohepatitis. Hepatology. 2008; 48(2):442-8.
17. Wong VWS, Vergniol J, Wong GLH, Foucher J, Chan HLY, Le Bail B, et al. Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease. Hepatology. 2010; 51(2):454-62.
18. Lupsor M, Badea R, Stefanescu H, Grigorescu M, Serban A, Radu C, et al. Performance of unidimensional transient elastography in staging non-alcoholic steatohepatitis. J Gastrointestin Liver Dis. 2010; 19(1):53-60.
19. Petta S, Di Marco V, Cammà C, Butera G, Cabibi D, Craxi A. Reliability of liver stiffness measurement in non‐alcoholic fatty liver disease: the effects of body mass index. Alimentary pharmacology & therapeutics. 2011; 33(12):1350-60.
20. Mahadeva S, Mahfudz AS, Vijayanathan A, Goh KL, Kulenthran A, Cheah PL. Performance of transient elastography (TE) and factors associated with discordance in non‐alcoholic fatty liver disease. Journal of digestive diseases. 2013; 14(11):604-10.
21. Wong VW-S, Vergniol J, Wong GL-H, Foucher J, Chan AW-H, Chermak F, et al. Liver stiffness measurement using XL probe in patients with nonalcoholic fatty liver disease. The American journal of gastroenterology. 2012; 107(12):1862-71.
22. Myers RP, Pomier‐Layrargues G, Kirsch R, Pollett A, Duarte‐Rojo A, Wong D, et al. Feasibility and diagnostic performance of the FibroScan XL probe for liver stiffness measurement in overweight and obese patients. Hepatology. 2012; 55(1):199-208.
23. Patel K, Wilder J. Fibroscan. Clinical Liver Disease. 2014; 4(5):97-101.
24. Ballestri S, Lonardo A, Romagnoli D, Carulli L, Losi L, Day CP, et al. Ultrasonographic fatty liver indicator, a novel score which rules out NASH and is correlated with metabolic parameters in NAFLD. Liver International. 2012; 32(8):1242-52.
25. Dasarathy S, Dasarathy J, Khiyami A, Joseph R, Lopez R, McCullough AJ. Validity of real time ultrasound in the diagnosis of hepatic steatosis: a prospective study. Journal of hepatology. 2009; 51(6):1061-7.
26. Schwenzer NF, Springer F, Schraml C, Stefan N, Machann J, Schick F. Non-invasive assessment and quantification of liver steatosis by ultrasound, computed tomography and magnetic resonance. Journal of hepatology. 2009; 51(3):433-45.
27. Tobari M, Hashimoto E, Yatsuji S, Torii N, Shiratori K. Imaging of nonalcoholic steatohepatitis: advantages and pitfalls of ultrasonography and computed tomography. Internal Medicine. 2009; 48(10):739-46.
28. Dasarathy S, Dasarathy J, Khiyami A, Joseph R, Lopez R, McCullough AJ. Validity of real time ultrasound in the diagnosis of hepatic steatosis: a prospective study. Journal of hepatology. 2009; 51(6):1061-7.
29. Saadeh S, Younossi ZM, Remer EM, Gramlich T, Ong JP, Hurley M, et al. The utility of radiological imaging in nonalcoholic fatty liver disease. Gastroenterology. 2002; 123(3):745-50.
30. Hannah WN, Harrison SA. Noninvasive imaging methods to determine severity of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. Hepatology. 2016; 64(6):2234-
| Files | ||
| Issue | Vol 58, No 11 (2020) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/acta.v58i11.5142 | |
| Keywords | ||
| Nonalcoholic Fatty Liver Disease Fibro scan Transabdominal ultrasonography | ||
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How to Cite
1.
Bahari A, Esmaeilzadeh A, Soltani M, Morovatdar N, Babaei N, Ganji A. How Good Is Trans Abdominal Ultrasound for Evaluating NAFLD in the General Population? A Cross-Sectional Study. Acta Med Iran. 2021;58(11):562-566.
