Elastography in the Diagnosis of Non-Alcoholic Fatty Liver Disease

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Abstract

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.

About the authors

Elena N. Shirokova

Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Email: elshirokova@yandex.ru
ORCID iD: 0000-0002-6819-0889

Elena Nikolaevna Shirokova - MD, PhD, Professor

SPIN-код: 7340-4526

Russian Federation

Chavdar S. Pavlov

Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Email: chpavlov@mail.ru
ORCID iD: 0000-0001-5031-9798

Chavdar Savov Pavlov - MD, PhD, Professor

SPIN-код: 5052-9020

Russian Federation

Anna D. Karaseva

Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Author for correspondence.
Email: karas_any@list.ru
ORCID iD: 0000-0002-9200-1590

Anna Dmitrievna Karaseva

1 bld.1, Pogodinskaya street, 119435 Moscow

SPIN-код: 6745-7823

Russian Federation

Aliya M. Alieva

Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Email: aliya1993@mail.ru
ORCID iD: 0000-0002-7606-2246

Aliya Mahmudovna Alieva - MD

SPIN-код: 2680-5872

Russian Federation

Alla V. Sedova

Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Email: sedovaav@yandex.ru
ORCID iD: 0000-0003-1644-264X

Alla Vladimirovna Sedova - MD, PhD

SPIN-код: 7863-2295

Russian Federation

Vladimir T. Ivashkin

Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Email: 2135833@mail.ru
ORCID iD: 0000-0002-6815-6015

Vladimir Trofimovich Ivashkin - MD, PhD, Professor

SPIN-код: 3551-0890

Russian Federation

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