Modern ultrasonic methods of diagnostics of hepatic steatosis
https://doi.org/10.18699/SSMJ20230402
Abstract
The prevalence of non-alcoholic fatty liver disease, according to various estimates, affects a quarter of the world population. Significant interest in this pathology is due to the high frequency of adverse liver (steatohepatitis, liver fibrosis and cirrhosis) and extrahepatic (association with cardiovascular disease) outcomes. One of the key areas is the timely diagnosis of liver steatosis. Reference diagnostic methods, which include liver biopsy and magnetic resonance imaging with assessment of liver fat proportion weighted by proton density, have objective practical and financial limitations for their routine use in detection and quantitative assessment of liver steatosis. Therefore, one of the current trends in hepatology is the development of inexpensive, widely applicable, and reliable noninvasive diagnostic tools. The aim of the present review is a comparative analysis of various ultrasound methods of liver steatosis diagnostics: qualitative, semi-quantitative and quantitative (estimation of hepatorenal index, controlled attenuation parameter). The presented publication reviews the currently available methods of detection and assessment of severity of liver steatosis based on ultrasound examination, including their classification, methodology and comparison of diagnostic efficiency with analysis of intra- and inter-operator reproducibility, sensitivity and specificity.
About the Authors
A. S. Kuznetsova
South-Ural State Medical University of Minzdrav of Russia
Russian Federation
Russian Federation
Alla S. Kuznetsova, candidate of medical sciences
454092, Chelyabinsk, Vorovskogo st., 64
A. I. Dolgushina
South-Ural State Medical University of Minzdrav of Russia
Russian Federation
Russian Federation
Anastasia I. Dolgushina, doctor of medical sciences
454092, Chelyabinsk, Vorovskogo st., 64
N. V. Smagina
South-Ural State Medical University of Minzdrav of Russia
Russian Federation
Russian Federation
Natalya V. Smagina, candidate of medical sciences
454092, Chelyabinsk, Vorovskogo st., 64
E. V. Lebedev
South-Ural State Medical University of Minzdrav of Russia
Russian Federation
Russian Federation
Evgeny V. Lebedev, candidate of medical sciences
454092, Chelyabinsk, Vorovskogo st., 64
V. V. Genkel
South-Ural State Medical University of Minzdrav of Russia
Russian Federation
Russian Federation
Vadim V. Genkel, candidate of medical sciences
454092, Chelyabinsk, Vorovskogo st., 64
References
1. Maevskaya M.V., Kotovskaya Yu.V., Ivashkin V.T., Tkacheva O.N., Troshina E.A., Shestakova M.V., Breder V.V., Geivandova N.I., Doshitsin V.L., Dudinskaya E.N., … Shamkhalova M.Sh. The national consensus statement on the management of adult patients with non-alcoholic fatty liver disease and main comorbidities. Terapevticheskiy arkhiv = Therapeutic Archive. 2022; 94(2):216–253. [In Russian]. doi: 10.26442/00403660.2022.02.201363
2. Ivashkin V.T., Maevskaya M.V., Pavlov Ch.S., Tikhonov I.N., Shirokova E.N., Bueverov A.O., Drapkina O.M., Shulpekova Yu.O., Tsukanov V.V., Mammaev S.N., Maev I.V., Palgova L.K. Diagnostics and treatment of non-alcoholic fatty liver disease: clinical guidelines of the Russian scientific liver society and the Russian gastroenterological association. Rossiyskiy zhurnal gastroenterologii, gepatologii, koloproktologii = Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2016;26(2):24–42. [In Russian]. doi: 10.22416/1382-4376-2016-26-2-24-42
3. Drapkina O.M., Korneeva O.N. Continuum of non-alcoholic fatty liver disease: from hepatic steatosis to cardiovascular risk. Ratsional’naya farmakoterapiya v kardiologii = Rational Pharmacotherapy in Cardiology. 2016;12(4):424–429. [In Russian]. doi: 10.20996/1819-6446-2016-12-4-424-429
4. Kleiner D.E., Brunt E.M., van Natta M., Behling C., Contos M.J., Cummings O.W., Ferrell L.D., Liu Y.C., Torbenson M.S., Unalp-Arida A., … Nonalcoholic Steatohepatitis Clinical Research Network. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology. 2005;41(6):1313–1321. doi: 10.1002/hep.20701
5. Bedossa P., FLIP Pathology Consortium. Utility and appropriateness of the fatty liver inhibition of progression (FLIP) algorithm and steatosis, activity, and fibrosis (SAF) score in the evaluation of biopsies of nonalcoholic fatty liver disease. Hepatology. 2014;60(2):565–575. doi: 10.1002/hep.27173
6. Venidiktova D.Yu., Borsukov A.V., Alipenkova A.V., Eremkina A.V., Tagil A.O., Trushova V.A. Ultrasound steatometry in patients with non-alcoholic fatty liver disease: pilot results. Klinicheskaya praktika = Clinical Practice. 2019;10(1):23–29. [In Russian]. doi: 10.17816/clinpract10123-29
7. Bakulin I.G., Sandler Yu.G., Keyan V.A., Vinnitskaya E.V., Drapun S.V. Noninvasive assessment of hepatic steatosis: myth or reality? Doktor.Ru = Doctor.Ru. 2015;(12):57–64. [In Russian].
8. Pirmoazen A.M., Khurana A., El Kaffas A., Kamaya A. Quantitative ultrasound approaches for diagnosis and monitoring hepatic steatosis in nonalcoholic fatty liver disease. Theranostics. 2020;10(9):4277–4289. doi: 10.7150/thno.40249
9. Hernaez R., Lazo M., Bonekamp S., Kamel I., Brancati F.L., Guallar E., Clark J.M. Diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver: A meta-analysis. Hepatology. 2011;54(3):1082–1090. doi: 10.1002/hep.24452
10. Palmentieri B., de Sio I., La Mura V., Masarone M., Vecchione R., Bruno S., Torella R., Persico M. The role of bright liver echo pattern on ultrasound B-mode examination in the diagnosis of liver steatosis. Dig. Liver Dis. 2006;38(7):485–489. doi: 10.1016/j.dld.2006.03.021
11. Mitkov V.V., Ivanishina T.V., Gogaeva I.M., Mitkova M.D., Bryukhovetsky Yu.A., Zabolotskaya N.V., Rudko G.G. Reproducibility of shear wave elastography in thyroid stiffness assessment. Ul’trazvukovaya i funktsional’naya diagnostika = Ultrasound and Functional Diagnostics. 2015;(6):27–35. [In Russian].
12. Sohail S., Memon M.A., Siddiqui K.J. Inter-observer agreement for detection and grading of hepatic steatosis – an ultrasound based study. PJR. 2018;28(1):30–34.
13. Cengiz M., Sentürk S., Cetin B., Bayrak A.H., Bilek S.U. Sonographic assessment of fatty liver: intraobserver and interobserver variability. Int. J. Clin. Exp. Med. 2014;7(12):5453–5460.
14. Hamaguchi M., Kojima T., Itoh Y., Harano Y., Fujii K., Nakajima T., Kato T., Takeda N., Okuda J., Ida K., Kawahito Y., Yoshikawa T., Okanoue T. The severity of ultrasonographic findings in nonalcoholic fatty liver disease reflects the metabolic syndrome and visceral fat accumulation. Am. J. Gastroenterol. 2007;102(12):2708–2715. doi: 10.1111/j.1572-0241.2007.01526.x
15. Marshall R.H., Eissa M., Bluth E.I., Gulotta P.M., Davis N.K. Hepatorenal index as an accurate, simple, and effective tool in screening for steatosis. AJR Am. J. Roentgenol. 2012;199(5):997–1002. doi: 10.2214/AJR.11.6677
16. Tanpowpong N., Panichyawat S. Comparison of sonographic hepatorenal ratio and the degree of hepatic steatosis in magnetic resonance imaging-proton density fat fraction. J. Ultrason. 2020;20(82):e169–e175. doi: 10.15557/JoU.2020.0028
17. Martín-Rodríguez J.L., Arrebola J.P., Jiménez-Moleón J.J., Olea N., González-Calvin J.L. Sonographic quantification of a hepato-renal index for the assessment of hepatic steatosis in comparison with 3T proton magnetic resonance spectroscopy. Eur. J. Gastroenterol. Hepatol. 2014;26(1):88–94. doi: 10.1097/MEG.0b013e3283650650
18. Tanpowpong N., Panichyawat S. Comparison of sonographic hepatorenal ratio and the degree of hepatic steatosis in magnetic resonance imaging-proton density fat fraction. J. Ultrason. 2020;20(82):e169–e175. doi: 10.15557/JoU.2020.0028
19. d’Souza J.C., Sultan L.R., Hunt S.J., Schultz S.M., Brice A.K., Wood A.K.W., Sehgal C.M. B-mode ultrasound for the assessment of hepatic fibrosis: a quantitative multiparametric analysis for a radiomics approach. Sci. Rep. 2019;9(1):8708. doi: 10.1038/s41598-019-45043-z
20. Stahlschmidt F.L., Tafarel J.R., Menini-Stahlschmidt C.M., Baena C.P. Hepatorenal index for grading liver steatosis with concomitant fibrosis. PLoS One. 2021;16(2):e0246837. doi: 10.1371/journal.pone.0246837
21. Li Y.S., Leng C.L., Chen M.T., Zhang W.K., Li X.J., Tang H.B., Shang H.C., Zhu L.H. Mouse hepatic neoplasm formation induced by trace level and low frequency exposure to diethylnitrosamine through β-catenin signaling pathway. Toxicol. Res. (Camb). 2015;23;5(1):210–223. doi: 10.1039/c5tx00317b
22. Kim K.B., Kim G.H., Song D.H., Park H.J., Kim C.W. Automatic segmentation of liver/kidney area with double-layered fuzzy C-means and the utility of hepatorenal index for fatty liver severity classification. Journal of Intelligent & Fuzzy Systems. 2020;39(1):925–936. doi: 10.3233/JIFS-191850
23. Shirokova E.N., Pavlov Ch.S., Karasyova A.D., Alieva A.M., Sedova A.V., Ivashkin V.T. Elastography in the diagnosis of nonalcoholic fatty liver disease. Vestnik Rossiyskoy akademii meditsinskikh nauk = Annals of the Russian Academy of Medical Sciences. 2019;(1):5–13. [In Russian]. doi: 10.15690/vramn1071
24. Masaki K., Takaki S., Hyogo H., Kobayashi T., Fukuhara T., Naeshiro N., Honda Y., Nakahara T., Ohno A., Miyaki D., … Chayama K. Utility of controlled attenuation parameter measurement for assessing liver steatosis in Japanese patients with chronic liver diseases. Hepatol. Res. 2013;43(11):1182–1189. doi: 10.1111/hepr.12094
25. Kjaergaard M., Lindvig K.P., Hansen C.D., Detlefsen S., Krag A., Thiele M. Hepatorenal index by Bmode ratio versus imaging and fatty liver index to diagnose steatosis in alcohol-related and nonalcoholic fatty liver disease. J. Ultrasound. Med. 2023;42(2):487–496. doi: 10.1002/jum.15991
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