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Advances in ultrasound elastography for nonalcoholic fatty liver disease

  • Special Feature: Review Article
  • Diagnosis and assessment of nonalcoholic fatty liver disease / nonalcoholic steatohepatitis using ultrasound elastography
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Abstract

The prevalence of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) has increased rapidly worldwide, making NAFLD/NASH an important global health problem from both a medical and socioeconomic standpoint. NAFLD is also regarded as a liver component of metabolic syndrome and is reported to be associated with the risk factors for metabolic syndrome. It has been suggested that NAFLD/NASH be recognized both as a liver-specific disease and as an early mediator of systemic diseases. Liver biopsy is recommended as the gold standard method for the diagnosis of NASH and for the staging of liver fibrosis in patients with NAFLD. However, because of its high cost, high risk, and high weightage as a healthcare resource, invasive liver biopsy is a poorly suited diagnostic test for such a highly prevalent condition. Therefore, the development of reliable noninvasive methods for the assessment of liver fibrosis has been sought to estimate the risk of progression of NASH to cirrhosis, estimate the risk of cardiovascular events, aid in the surveillance for HCC, and guide therapy in patients with NAFLD/NASH. In this review, we highlight the principles and recent advances in ultrasound elastography techniques (Real-time Tissue Elastography®, vibration-controlled transient elastography, point shear wave elastography, and two-dimensional shear wave elastography) used to evaluate the liver fibrosis stage and steatosis grade in patients with NAFLD.

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Abbreviations

AASLD:

American Association for the Study of Liver Disease

ALT:

ALANINE AMINOTRANSFERASE

ARFI:

Acoustic radiation force impulse

BMI:

Body mass index

CAP:

Controlled attenuation parameter

EASL:

European Association for the Study of the Liver

FDA:

Food and Drug Administration

HCC:

Hepatocellular carcinoma

JSG:

Japanese Society of Gastroenterology

kPa:

Kilopascal

LSM:

Liver stiffness measurement

NAFL:

Nonalcoholic fatty liver

NAFLD:

Nonalcoholic fatty liver disease

NAS:

NAFLD activity score

NASH:

Nonalcoholic steatohepatitis

pSWE:

Point shear wave elastography

ROI:

Region of interest

2D-SWE:

Two-dimensional shear wave elastography

T2DM:

Type 2 diabetes mellitus

US:

Ultrasonography

VCTE:

Vibration-controlled transient elastography

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawaku, 3-9 Fukuura, Kanazawaku, Yokohama, 236-0004, Japan

    Masato Yoneda, Yasushi Honda, Asako Nogami, Kento Imajo & Atsushi Nakajima

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  1. Masato Yoneda
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  2. Yasushi Honda
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  3. Asako Nogami
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  4. Kento Imajo
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  5. Atsushi Nakajima
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Correspondence to Atsushi Nakajima.

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Yoneda, M., Honda, Y., Nogami, A. et al. Advances in ultrasound elastography for nonalcoholic fatty liver disease. J Med Ultrasonics 47, 521–533 (2020). https://doi.org/10.1007/s10396-020-01040-8

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