Diagnostic performance of fibroscan and computed tomography in 322 normal alanine aminotransferase non‐obese non‐alcoholic fatty liver disease patients diagnosed by ultrasound

Aims of the study To compare the evaluation of various non‐invasive examination include ultrasound, fibroscan and computed tomography (CT) in normal alanine aminotransferase (ALT) non‐obese patients, to analyse the consistency and advantages among these non‐invasive examination in non‐alcoholic fatty liver disease (NAFLD) patients. Methods used to conduct the study About 322 cases of non‐obese NAFLD patients (BMI < 25 kg/m 2 ) with normal ALT were enroled. All patients were diagnosed with fatty liver by abdominal ultrasonography. Meanwhile, computed tomography and fibroscan were used to evaluate the existence and severity of fatty liver. Results of the study A 47.52% and 67.70% patients who diagnosed as NAFLD by ultrasound were unable to be diagnosed with fatty liver in accordance with the standard of controlled attenuation parameter (CAP) value by fibroscan and liver/spleen density ratio (L/S ratio) by CT. The evaluation of NAFLD by CAP standard were influenced by several factors, while only age and Triglyceride (TG) may affect the judgement of fatty liver when CT was used. Liver stiffness measurement (LSM) affects the diagnostic coincidence rate of fibroscan, CT and ultrasound. Statistical difference could be found among different LSM groups in the severity of NAFLD evaluated by Fibroscan and CT. Conclusions drawn from the study and clinical implications There is a discrepancy in the evaluation NAFLD by fibroscan, CT and ultrasound. LSM may affect the diagnostic coincidence rate of fibroscan, CT and ultrasound. Non‐invasive assessment model including multiple clinical data and image results should be investigated in evaluating the degree of NAFLD. Interpretation of the diagnostic results about fibroscan, CT and ultrasound in the evaluation of NAFLD should take into account the specific clinical data of each patient.