Non-invasive imagistic techniques of diagnostic of hepatical steatosis
Keywords:
non-alcoholic fatty liver disease, hepatic steatosis, Imaging techniques, Quantitative evaluation, Quantitative ultrasoundAbstract
Fatty liver disease (FLD) is defined as the accumulation of liver fat (hepatic steatosis) in >5% of hepatocytes with or without inflammation and fibrosis. Quantitative imaging techniques can provide objective continuous metrics associated with liver fat content and be recorded for comparison when patients receive check-ups to evaluate changes in liver fat content. The aim of the study was to identify the accuracy of non-invasive imaging techniques in diagnostic FLD. Material and Methods. A total of 1034 studies were identified on the PubMed database. After removing duplicates, 728 titles, and abstracts were screened. Analysed correlation between histopathologically confirmed steatosis and imaging techniques. Results. Controlled attenuation parament (CAP), ATI Attenuation imaging (ATI), Attenuation measurement function (ATT), and Hepatorenal index were analyzed. CAP is the first method based on attenuation of the ultrasound beam, but the limitations of this method are caused by the impossibility to determine the exact location of the region of interest. ATT and ATI have been developed to improve this situation, and these metrics can be used to evaluate the degree of fatty liver on grayscale ultrasonography in real-time with a correct region of interest.CAP showed suboptimal performance in quantifying liver fat content, especially in mild steatosis, which limited its use as a golden standard. Conclusions. Greyscale ultrasound has limited diagnostic performance in mild steatosis. The CAP method is more difficult to be used in overweight and obese patients, but these are the most common patients in FLD. ATT/ATI are the universal methods.
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