scholarly journals Liver stiffness quantification in biopsyproven nonalcoholic fatty liver disease patients using shear wave elastography in comparison with transient elastography

2020 ◽  
Author(s):  
Adele Taibbi ◽  
Salvatore Petta ◽  
Domenica Matranga ◽  
Giovanni Caruana ◽  
Roberto Cannella ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Shear Wave ◽  
Fatty Liver Disease ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Nonalcoholic Fatty Liver

scholarly journals Evaluation and Diagnosis of Nonalcoholic Fatty Liver Disease/Steatohepatitis by K-Fold Validation Based on Pathology, Including Real-Time Shear Wave Elastography and Noninvasive Biomarkers

2020 ◽  
Author(s):  
Jie Zhou ◽  
Feng Yan ◽  
Jinshun Xu ◽  
Qiang Lu ◽  
Xianglan Zhu ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Shear Wave ◽  
Fatty Liver Disease ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Nonalcoholic Fatty Liver ◽  
Noninvasive Biomarkers ◽  
Diagnostic Indicator

Abstract ObjectivesThis study aim to investigate the diagnostic accuracy of shear wave elastography (SWE) for diagnosing nonalcoholic steatohepatitis (NASH) and staging fibrosis in a cohort patients confirmed nonalcoholic fatty liver disease (NAFLD) by liver biopsy.MethodsA total of 86 NAFLD patients and 17 normal-control were enrolled. The performance of SWE to diagnose NASH and stage fibrosis was evaluated on the basis of histopathological inflammation grades and fibrosis stages according to Kleiner/Brunt et al.’s criteria classification, and compared to previous reported four noninvasive serum fibrotic scores, coupled with the k-fold-cross-validation and Delong test. Meanwhile, influence of steatosis on liver stiffness measurements (LSMs) of SWE was also studied.ResultsLSMs of SWE proved to be an excellent diagnostic indicator for detecting NASH (AUROC＝0.85), and fibrotic NASH: ≥F2 stage (AUROC＝0.92), ≥F3 stage (AUROC＝0.94) and =F4 stage (AUROC ＝0.94) with the cutoff values were 7.55, 7.65, 8.25 and 11.80 kPa, respectively. Compared with serum fibrotic scores, SWE had the highest AUROC for predicting ≥F2, ≥F3, =F4 by Delong test (all P＜0.05). No statistic differences of LSMs were found among different steatosis levels (P=0.29).ConclusionThe stiffness reconstructions based on SWE could be used to noninvasively identify NASH and stage fibrosis in NAFLD patients. Moreover, the diagnosis efficiency of LSMs on SWE could not be influenced by steatosis.

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 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 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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