Can Nonfibrotic Nonalcoholic Steatohepatitis Be Effectively Identified by Supersonic Shear Imaging?

Supersonic shear imaging (SSI) is a relatively new technique to measure the elasticity of target tissues based on the shear wave propagation. The aim of this study was to evaluate the value of SSI in discriminating nonfibrotic nonalcoholic steatohepatitis (NASH) from the less severe nonalcoholic fatty liver disease (NAFLD), NASH with fibrosis, and the normal liver, as well as the relationship between various NAFLD pathologic or biochemical findings and SSI liver elasticity. Rabbits with NAFLD of different degrees were subjected to SSI for liver elasticity measurement. Plasma was collected for biochemical examinations, and liver tissues were harvested for pathologic assessment. Results showed that liver elasticity of rabbits with nonfibrotic NASH was significantly different from that of rabbits with simple steatosis, borderline, NASH with fibrosis, and normal liver (P<0.05) and the areas under the receiver operating characteristic curve of SSI for predicting nonfibrotic NASH and NASH with fibrosis were 0.997 and 0.967, respectively, and the optimal cutoff values were 10.17 kPa and 12.82 kPa, respectively. Multivariate analysis showed that only fibrosis and inflammation were the independent factors affecting liver elasticity of NAFLD (P≤0.001), while inflammation, steatosis, and ballooning degeneration were all independently related to liver elasticity in rabbits without fibrosis (P<0.01). In addition, alanine aminotransferase was the only biochemical factor independently related to liver elasticity (P≤0.001). Our results indicate that SSI can effectively identify nonfibrotic NASH in rabbits based on the difference in liver elasticity and the difference is related to the various pathologic changes, including fibrosis, inflammation, steatosis, and ballooning degeneration.

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Circulating Levels of Pro-Neurotensin and Its Relationship with Nonalcoholic Steatohepatitis and Hepatic Lipid Metabolism

Metabolites ◽

10.3390/metabo11060373 ◽

2021 ◽

Vol 11 (6) ◽

pp. 373

Author(s):

Beatriz Villar ◽

Laia Bertran ◽

Carmen Aguilar ◽

Jessica Binetti ◽

Salomé Martínez ◽

...

Keyword(s):

Lipid Metabolism ◽

Nonalcoholic Steatohepatitis ◽

Liver Lipid ◽

Normal Liver ◽

Normal Weight ◽

Published Data ◽

Mrna Levels ◽

Nonalcoholic Fatty Liver ◽

Hepatic Expression ◽

Liver Lipid Metabolism

Recent studies suggest a link between pro-neurotensin (pro-NT) and nonalcoholic fatty liver disease (NAFLD), but the published data are conflicting. Thus, we aimed to analyze pro-NT levels in women with morbid obesity (MO) and NAFLD to investigate if this molecule is involved in NAFLD and liver lipid metabolism. Plasma levels of pro-NT were determined in 56 subjects with MO and 18 with normal weight (NW). All patients with MO were subclassified according to their liver histology into the normal liver (NL, n = 20) and NAFLD (n = 36) groups. The NAFLD group had 17 subjects with simple steatosis (SS) and 19 with nonalcoholic steatohepatitis (NASH). We used a chemiluminescence sandwich immunoassay to quantify pro-NT in plasma and RT-qPCR to evaluate the hepatic mRNA levels of several lipid metabolism-related genes. We reported that pro-NT levels were significantly higher in MO with NAFLD than in MO without NAFLD. Additionally, pro-NT levels were higher in NASH patients than in NL. The hepatic expression of lipid metabolism-related genes was found to be altered in NAFLD, as previously reported. Additionally, although pro-NT levels correlated with LDL, there was no association with the main lipid metabolism-related genes. These findings suggest that pro-NT could be related to NAFLD progression.

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2D-shear wave elastography: number of acquisitions can be reduced according to clinical setting

Insights into Imaging ◽

10.1186/s13244-021-01090-7 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Marco Dioguardi Burgio ◽

Jules Grégory ◽

Maxime Ronot ◽

Riccardo Sartoris ◽

Gilles Chatellier ◽

...

Keyword(s):

Shear Wave ◽

Liver Stiffness ◽

Shear Wave Elastography ◽

Mean Value ◽

Factors Affecting ◽

Absolute Value ◽

Factors Associated ◽

Supersonic Shear Imaging ◽

The Mean ◽

The Difference

Abstract Background The factors affecting intra-operator variability of two-dimensional shear wave elastography (2D-SWE) have not been clearly established. We evaluated 2D-SWE variability according to the number of measurements, clinical and laboratory features, and liver stiffness measurements (LSM). Methods At least three LSM were performed in 452 patients who underwent LSM by 2D-SWE (supersonic shear imaging) out of an initial database of 1650 patients. The mean value of the three LSM was our best measurement method. Bland–Altman plots were used to evaluate intra-operator variability when considering only one, or the first two measurements. Variability was assessed by taking the absolute value of the difference between the first LSM and the mean of the three LSM. Logistic regression was used to assess the factors associated with the highest tertile of variability. Results The limit of agreement was narrower with the mean of the first and second measurements than with each measurement taken separately (− 2.83 to 2.99 kPa vs. − 5.86 to 6.21 kPa and − 5.77 to 5.73 kPa for the first and second measurement, respectively). A BMI ≥ 25 kg/m2 and a first LSM by 2D-SWE ≥ 7.1 kPa increased the odds of higher variability by 3.4 and 3.9, respectively. Adding a second LSM didn’t change the variability in patients with BMI < 25 and a first LSM by 2D-SWE < 7.1 kPa. Conclusions Intra-operator variability of LSM by 2D-SWE increases with both a high BMI and high LSM value. In patients with BMI < 25 kg/m2 and a first LSM < 7.1 kPa we recommend performing only one LSM.

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Formulation for Effective Screening and Management of Nonalcoholic Steatohepatitis: Noninvasive NAFLD Management Strategy

Gastroenterology Research and Practice ◽

10.1155/2016/6343656 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Kanae Hirose ◽

Tsutomu Kanefuji ◽

Takeshi Suda ◽

Souichi Sugitani ◽

Keisuke Nagasaki ◽

...

Keyword(s):

Shear Wave ◽

Wave Velocity ◽

Shear Wave Velocity ◽

Nonalcoholic Steatohepatitis ◽

High Throughput Screening ◽

Characteristic Curve ◽

Biochemical Properties ◽

Nonalcoholic Fatty Liver ◽

Left Lateral Segment ◽

The Right

To establish a versatile means for screening and management of nonalcoholic steatohepatitis (NASH), shear wave velocity was measured in 20 normal controls and 138 consecutive nonalcoholic fatty liver disease (NAFLD) cases. Referencing biochemical properties in 679 healthy volunteers, a formula to distinguish NASH suspects was established and validated in another cohort of 138 histologically proven NAFLD cases. NASH and simple steatosis (SS) suspects were selected based on a plot of shear wave velocity against age. A formula consisting of five factors (γ-glutamyl transpeptidase, alkaline phosphatase, platelet counts, body mass index, and presence/absence of type 2 diabetes mellitus) distinguished NASH suspects from SS suspects with area under the receiver operating characteristic curve values of 86% and 84% in the development and validation cohorts. Among 25 NAFLD cases in which shear wave velocity was repeatedly measured, 8 and 9 cases revealed an increase or decrease, respectively, of shear wave velocity in the entire liver, and the corresponding change in shear wave velocity was primarily observed in the right lobe or the left lateral segment, respectively. These results suggest that the new formula and sequential shear wave velocity measurements at each segment enable high throughput screening of NASH suspects and noninvasive assessment of pathophysiological alleviation/aggravation in cases of NASH.

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Relationship between IL-8 Circulating Levels and TLR2 Hepatic Expression in Women with Morbid Obesity and Nonalcoholic Steatohepatitis

International Journal of Molecular Sciences ◽

10.3390/ijms21114189 ◽

2020 ◽

Vol 21 (11) ◽

pp. 4189 ◽

Cited By ~ 1

Author(s):

Teresa Auguet ◽

Laia Bertran ◽

Jessica Binetti ◽

Carmen Aguilar ◽

Salomé Martínez ◽

...

Keyword(s):

Morbid Obesity ◽

Nonalcoholic Steatohepatitis ◽

Normal Liver ◽

Normal Weight ◽

Nonalcoholic Fatty Liver ◽

Hepatic Expression ◽

Tnf Α ◽

Noninvasive Biomarkers ◽

The Relationship ◽

Circulating Levels

The progression of nonalcoholic fatty liver disease (NAFLD) to nonalcoholic steatohepatitis (NASH) is linked to systemic inflammation. Currently, two of the aspects that need further investigation are diagnosis and treatment of NASH. In this sense, the aim of this study was to assess the relationship between circulating levels of cytokines, hepatic expression of toll-like receptors (TLRs), and degrees of NAFLD, and to investigate whether these levels could serve as noninvasive biomarkers of NASH. The present study assessed plasma levels of cytokines in 29 normal-weight women and 82 women with morbid obesity (MO) (subclassified: normal liver (n = 29), simple steatosis (n = 32), and NASH (n = 21)). We used enzyme-linked immunosorbent assays (ELISAs) to quantify cytokine and TLR4 levels and RTqPCR to assess TLRs hepatic expression. IL-1β, IL-8, IL-10, TNF-α, tPAI-1, and MCP-1 levels were increased, and adiponectin levels were decreased in women with MO. IL-8 was significantly higher in MO with NASH than in NL. To sum up, high levels of IL-8 were associated with the diagnosis of NASH in a cohort of women with morbid obesity. Moreover, a positive correlation between TLR2 hepatic expression and IL-8 circulating levels was found.

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Low-Density Lipoprotein (LDL)-Triglyceride and Its Ratio to LDL-Cholesterol as Diagnostic Biomarkers for Nonalcoholic Steatohepatitis

The Journal of Applied Laboratory Medicine ◽

10.1093/jalm/jfaa044 ◽

2020 ◽

Vol 5 (6) ◽

pp. 1206-1215 ◽

Cited By ~ 1

Author(s):

Yuki Fujii ◽

Kazuhiro Nouso ◽

Hiroshi Matsushita ◽

Kazuya Kariyama ◽

Toshihiro Sakurai ◽

...

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Steatohepatitis ◽

Ldl Cholesterol ◽

Characteristic Curve ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Low Density ◽

Diagnostic Biomarkers ◽

Nonalcoholic Fatty Liver

Abstract Background Nonalcoholic fatty liver disease (NAFLD) is the most common type of liver disease, but it is difficult to distinguish its pathogenic phenotype, nonalcoholic steatohepatitis (NASH), from nonalcoholic fatty liver (NAFL) without a liver biopsy. We analyzed serum lipids, including low-density lipoprotein triglyceride (LDL-TG), to elucidate their usefulness for diagnosing NASH. Patients and Methods Serum samples obtained from 35 NASH and 9 NAFL biopsy-confirmed patients and 6 healthy volunteers (HLT) were studied for 13 lipid-related markers and compared between HLT, NAFL, and NASH groups. The relationship between histological findings and the lipid markers was also analyzed. Results There were significant differences in triglyceride, LDL-TG, the ratio of LDL-TG to the LDL-cholesterol (LDL-TG/LDL-C), small dense LDL-C, and apolipoprotein E between the three groups. Among the 5 lipid components, serum LDL-TG level and the ratio of LDL-TG to the LDL-cholesterol (LDL-TG/LDL-C) were significantly elevated in NASH. The median concentrations of LDL-TG in HLT, NAFL, and NASH were 9, 15, and 20 mg/dL (P < 0.001), and those of LDL-TG/LDL-C were 0.097, 0.102, and 0.173 (P < 0.001), respectively. Although the degree of steatosis was not correlated with the LDL-TG/LDL-C, the ratio was significantly higher in patients with lobular inflammation (P = 0.071), ballooning (P = 0.031), and fibrosis (P < 0.001). The area under the receiver operating characteristic curve of the ratio for distinguishing NASH from NAFL was 0.857. The rest of studied markers showed no significant utility. Conclusion Serum LDL-TG levels and the LDL-TG/LDL-C ratio might serve as simple and noninvasive diagnostic biomarkers for NASH.

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Value of perfusion parameters histogram analysis of triphasic CT in differentiating intrahepatic mass forming cholangiocarcinoma from hepatocellular carcinoma

Scientific Reports ◽

10.1038/s41598-021-02667-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Fang Zhao ◽

Guodong Pang ◽

Xuejing Li ◽

Shuo Yang ◽

Hai Zhong

Keyword(s):

Characteristic Curve ◽

Liver Perfusion ◽

Normal Liver ◽

Mean Value ◽

Ct Scans ◽

Arterial Blood ◽

Specificity And Sensitivity ◽

The Mean ◽

The Difference ◽

Triphasic Ct

AbstractWe aim to gain further insight into identifying differential perfusion parameters and corresponding histogram parameters of intrahepatic mass-forming cholangiocarcinoma (IMCC) from hepatocellular carcinomas (HCCs) on triphasic computed tomography (CT) scans. 90 patients with pathologically confirmed HCCs (n = 54) and IMCCs (n = 36) who underwent triple-phase enhanced CT imaging were included. Quantitative analysis of CT images derived from triphasic CT scans were evaluated to generate liver perfusion and histogram parameters. The differential performances, including the area under the receiver operating characteristic curve (AUC), specificity, and sensitivity were assessed. The mean value, and all thepercentiles of the arterial enhancement fraction (AEF) were significantly higher in HCCs than in IMCCs. The difference in hepatic arterial blood supply perfusion (HAP) and AEF (ΔHAP = HAPtumor − HAPliver, ΔAEF = AEFtumor − AEFliver) for the mean perfusion parameters and all percentile parameters between tumor and peripheral normal liver were significantly higher in HCCs than in IMCCs. The relative AEF (rAEF = ΔAEF/AEFliver), including the mean value and all corresponding percentile parameters were statistically significant between HCCs and IMCCs. The 10th percentiles of the ΔAEF and rAEF had the highest AUC of 0.788 for differentiating IMCC from HCC, with sensitivities and specificities of 87.0%, 83.3%, and 61.8%, 64.7%, respectively. Among all parameters, the mean value of ∆AEF, the 75th percentiles of ∆AEF and rAEF, and the 25th percentile of HFtumor exhibited the highest sensitivities of 94.4%, while the 50th percentile of rAEF had the highest specificity of 82.4%. AEF (including ΔAEF and rAEF) and the corresponding histogram parameters derived from triphasic CT scans provided useful value and facilitated the accurate discrimination between IMCCs and HCCs.

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