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Abstract Details
Conventional ultrasound for diagnosis of hepatic steatosis is better than believed
Z Gastroenterol. 2021 Jun 25. doi: 10.1055/a-1491-1771. Online ahead of print.
Christoph F Dietrich1, Long Shi2, Axel Löwe1, Yi Dong3, Andrej Potthoff4, Zeno Sparchez5, Andreas Teufel6, Sabine Guth7, Jonas Koch1, Richard G Barr8, Xin-Wu Cui9
Author information
1Department Allgemeine Innere Medizin, Kliniken Hirslanden, Beau Site, Salem und Permanence, Bern, Switzerland.
4Gastroenterology and Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
5Department of Internal Medicine-Gastroenterology, University of Medicine and Pharmacy, Cluj-Napoca, Romania.
6Division of Hepatology, Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
7Conradia Medical Prevention Hamburg, Hamburg, Deutschland.
8Northeastern Ohio Medical University, Southwoods Imaging, Youngstown, OH, USA.
9Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Abstract
Background: Hepatic steatosis is a condition frequently encountered in clinical practice, with potential progression towards fibrosis, cirrhosis, and hepatocellular carcinoma. Detection and staging of hepatic steatosis are of most importance in nonalcoholic fatty liver disease (NAFLD), a disease with a high prevalence of more than 1 billion individuals affected. Ultrasound (US) is one of the most used noninvasive imaging techniques used in the diagnosis of hepatic steatosis. Detection of hepatic steatosis with US relies on several conventional US parameters, which will be described. US is the first-choice imaging in adults at risk for hepatic steatosis. The use of some scoring systems may add additional accuracy especially in assessing the severity of hepatic steatosis.
Summary: In the presented paper, we discuss screening and risk stratification, ultrasound features for diagnosing hepatic steatosis, B-mode criteria, focal fatty patterns and Doppler features of the hepatic vessels, and the value of the different US signs for the diagnosis of liver steatosis including classifying the severity of steatosis using different US scores. Limitations of conventional B-mode and Doppler features in the evaluation of hepatic steatosis are also discussed, including those in grading and assessing the complications of steatosis, namely fibrosis and nonalcoholic steatohepatitis.