Open AccessElastography in the Diagnosis of Non-Alcoholic Fatty Liver Disease
Author(s) -
Elena Shirokova,
Широкова Елена Николаевна,
Chavdar S Pavlov,
Павлов Чавдар Савов,
Anna D. Karaseva,
Карасёва Анна Дмитриевна,
Aliya Alieva,
Алиева Алия Махмудовна,
Alla Sedova,
Седова Алла Владимировна,
Ivashkin Vt,
Ивашкин Владимир Трофимович
Publication year - 2019
Publication title -
vestnik rossijskoj akademii medicinskih nauk
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.122
H-Index - 15
eISSN - 2414-3545
pISSN - 0869-6047
DOI - 10.15690/vramn1071
Subject(s) - transient elastography , medicine , fatty liver , steatosis , elastography , liver biopsy , radiology , fibrosis , cirrhosis , chronic liver disease , liver fibrosis , pathological , pathology , biopsy , disease , ultrasound
Currently, there has been a progressive increase in prevalence of one of the most common diffuse chronic liver diseases ― non-alcoholic fatty liver disease (NAFLD). Assessment of the stages of liver fibrosis and steatosis is prognostically significant in diagnosis of NAFLD. Routine diagnostic methods are either not able to accurately assess the severity of fibrosis and steatosis (ultrasound, laboratory tests), or cannot be used as a simple screening tool (liver biopsy) due to such limitations as invasiveness, dependence on pathologist qualification, high cost, and limited region of interest. Over the last two decades, the great progress has been made in non-invasive visualization of pathological changes in liver diseases. In this review, we examined the diagnostic characteristics of the most widely used non-invasive imaging methods in clinical practice, available for quantitative determination of fat and fibrosis in the liver: transient elastography with controlled attenuation parameter (CAP), acoustic radiation force impulse (ARFI) and shear wave elastography (SWE). Comparing these methods and their limitations, we came to conclusion, that elastographic methods (slightly more ARFI and SWE) are able to verify the F3, F4 stages of fibrosis in NAFLD with high sensitivity and specificity (90%); however, they are less accurate for early stages. Elastographic techniques have moderate accuracy in identifying the degree of steatosis due to the lack of uniform standardized cut-off values of CAP.