scholarly journals Application of transient elastography in nonalcoholic fatty liver disease

2020 ◽  
Vol 26 (2) ◽  
pp. 128-141 ◽  
Author(s):  
Xinrong Zhang ◽  
Grace Lai-Hung Wong ◽  
Vincent Wai-Sun Wong
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Transient Elastography ◽  
Liver Steatosis ◽  
Liver Stiffness ◽  
The United States ◽  
Initial Assessment ◽  
Nonalcoholic Fatty Liver

Nonalcoholic fatty liver disease (NAFLD) is currently the most common chronic liver disease worldwide. Although it has become one of the leading causes of cirrhosis and hepatocellular carcinoma in the Western world, the proportion of NAFLD patients developing these complications is rather small. Therefore, current guidelines recommend noninvasive tests for the initial assessment of NAFLD. Among the available non-invasive tests, transient elastography by FibroScan<sup>®</sup> (Echosens, Paris, France) is commonly used by hepatologists in Europe and Asia, and the machine has been introduced to the United States in 2013 with rapid adoption. Transient elastography measures liver stiffness and the controlled attenuation parameter simultaneously and can serve as a one-stop examination for both liver steatosis and fibrosis. Liver stiffness measurement also correlates with clinical outcomes and can be used to select patients for varices screening. Although obesity is a common reason for measurement failures, the development of the XL probe allows successful measurements in the majority of obese patients. This article reviews the performance and limitations of transient elastography in NAFLD and highlights its clinical applications. We also discuss the reliability criteria for transient elastography examination and factors associated with false-positive liver stiffness measurements.

scholarly journals Vibration-Controlled Transient Elastography and Controlled Attenuation Parameter for the Diagnosis of Liver Steatosis and Fibrosis in Patients with Nonalcoholic Fatty Liver Disease

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 787
Author(s):  
Sebastian Zenovia ◽  
Carol Stanciu ◽  
Catalin Sfarti ◽  
Ana-Maria Singeap ◽  
Camelia Cojocariu ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Hepatic Steatosis ◽  
Fatty Liver Disease ◽  
Transient Elastography ◽  
Liver Steatosis ◽  
Controlled Attenuation Parameter ◽  
Nonalcoholic Fatty Liver ◽  
Attenuation Parameter

Vibration-Controlled Transient Elastography (VCTE) with Controlled Attenuation Parameter (CAP) is a widely used non-invasive technique for concomitant assessment of liver steatosis and fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). We aimed to evaluate the level both of hepatic steatosis and fibrosis as well as the associated risk factors in patients referred to our unit with clinically suspected NAFLD or diagnosed by abdominal ultrasonography. Two hundred four patients were prospectively included in this study and assessed by VCTE with CAP. The final analysis included 181 patients with reliable liver stiffness measurements (LSMs) (53% female, mean age 57.62 ± 11.8 years and BMI 29.48 ± 4.85 kg/m2). According to the cut-off values for steatosis grading, there were 10 (5.5%) patients without steatosis (S0), 30 (16.6%) with mild (S1), 45 (24.9%) moderate (S2), and 96 (53%) severe (S3) steatosis. Based on LSM, there were 73 (40.3%) patients without fibrosis (F0), 42 (23.2%) with mild (F1), 32 (17.7%) significant (F2), 19 (10.5%) advanced (F3) fibrosis, and 15 (8.3%) with cirrhosis (F4). In addition, we found an association between several metabolic components and hepatic steatosis and fibrosis. Thus, in the multivariate analysis, higher BMI, fasting plasma glucose, triglycerides, low-density lipoprotein cholesterol, and serum uric were associated with increased CAP. Furthermore, higher serum uric acid and alpha-fetoprotein together with lower platelets count and albumin levels were associated with increased LSM. The assessment of steatosis and fibrosis using VCTE and CAP should be performed in all patients with suspected or previously diagnosed NAFLD in units with available facilities.

scholarly journals Comparison of Transient Elastography and Liver Biopsy in Assessing Fibrosis in Patients with Nonalcoholic Fatty Liver Disease

2021 ◽  
Vol 5 (1) ◽  
pp. 38-43
Author(s):  
Gaurav Bachhav ◽  
Lokesh Locheruvapalli Venkateshappa ◽  
Balekuduru Avinash ◽  
Manjunath Patil ◽  
Satyaprakash Bonthala Subbara ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Biopsy ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Predictive Values ◽  
Nonalcoholic Fatty Liver ◽  
Severe Fibrosis

Nonalcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease. Ultrasound-based transient elastography (TE) or TE of the liver is a noninvasive tool for effectively evaluating liver stiffness and fibrosis. The study aimed to compare the accuracy of TE as assessed by Fibroscan with liver biopsy in staging fibrosis in patients with NAFLD. Consecutive NAFLD patients (N = 72) were prospectively enrolled. TE evaluation was performed with Fibroscan and compared with liver biopsy, which is a reference standard. Fibrosis was staged according to the METAVIR scoring system (Meta-analysis of Histological Data in Viral Hepatitis). TE scores and biopsy-related fibrosis stages were correlated. Diagnostic accuracy (sensitivity, specificity, positive and negative predictive values) of TE was evaluated. Data were analyzed using software R v3.6.3. Liver biopsy showed that 36.11% of patients did not exhibit fibrosis, whereas 25, 16.67, 15.28, and 6.94% of patients had stage F1 (por-tal/mild fibrosis), F2 (periportal/moderate fibrosis), F3 (bridging/severe fibrosis), and F4 (cirrhosis/advanced fibrosis), respectively. TE showed that 50% of patients had cirrhosis, whereas 20.83,15.28, and 13.86% of patients had mild, moderate, and severe fibrosis, respectively. TE had 71% accuracy, 89% sensitivity, and 38% specificity in diagnosing the severity of fibrosis. Hence, it can be implemented as a noninvasive alternative diagnostic tool for understanding the severity of fibrosis in patients with NAFLD. Moreover, it can also be used for quick early diagnosis of NAFLD, reliable staging of fibrosis, and understanding the need for liver transplantation in patients with NAFLD.

scholarly journals Elevated Th22 cells correlated with Th17 cells in patients with high liver stiffness in nonalcoholic fatty liver disease

2018 ◽  
Vol 16 ◽  
pp. 205873921880267 ◽  
Author(s):  
Si-Biao Su ◽  
Wen Chen ◽  
Fei-Fei Huang ◽  
Jian-Feng Zhang
Keyword(s):  
Flow Cytometry ◽  
Liver Disease ◽  
Plasma Level ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Th17 Cells ◽  
Liver Stiffness ◽  
Nonalcoholic Fatty Liver ◽  
Th22 Cells

The aims of this article are to investigate the effects of Th22 and Th17 cells and plasma cytokines in patients with nonalcoholic fatty liver disease (NAFLD) and to examine the correlation between Th22 and Th17 cells levels and disease progression. Blood samples from 70 patients with NAFLD and 26 healthy controls (HCs) were collected. Flow cytometry and enzyme-linked immunosorbent assay (ELISA) analysis were performed. ELISA revealed interleukin (IL)-22 plasma level in FibroScan subgroup patients was 2.2-fold higher than that in the HCs ( P < 0.01), body mass index (BMI) subgroup patients were 2.3-fold higher than HCs ( P < 0.01), IL-17A plasma level was 5.6-fold higher in FibroScan subgroup patients than that in the HCs ( P < 0.01), and 5.8-fold higher in BMI subgroup than HCs ( P < 0.01). Flow cytometry revealed median proportions of Th22 cells in FibroScan group was greater than that in the HCs (3.85% vs 0.86%; P < 0.001). Similar results were obtained for Th17 cells (6.36% vs 0.9%; P < 0.001). The liver stiffness measurement value was highly correlated with the proportion of Th17 and Th22 cells and moderately correlated with the plasma level of IL-17A, IL-22, and the BMI value. In conclusion, the elevated proportions of Th17 and Th22 cells were significantly correlated with the degree of liver cirrhosis in NAFLD patients. They may play an inflammatory and immune response role in progression from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH) or fibrosis.

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