Document Detail


Detection of non-alcoholic steatohepatitis in patients with morbid obesity before bariatric surgery: preliminary evaluation with acoustic radiation force impulse imaging.
MedLine Citation:
PMID:  22648049     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the utility of acoustic radiation force impulse (ARFI) imaging, with the determination of shear wave velocity (SWV), to differentiate non-alcoholic fatty liver disease (NAFLD) from non-alcoholic steatohepatitis (NASH) in patients with morbid obesity before bariatric surgery.
METHODS: Thirty-two patients with morbid obesity were evaluated with ARFI and conventional ultrasound before bariatric surgery. The ARFI and ultrasound results were compared with liver biopsy findings, which is the reference standard. The patients were classed according to their histological findings into three groups: group A, simple steatosis; group B, inflammation; and group C, fibrosis.
RESULTS: The median SWV was 1.57 ± 0.79 m/s. Hepatic alterations were observed in the histopathological findings for all the patients in the study (100 %), with the results of the laboratory tests proving normal. Differences in SWV were also observed between groups A, B and C: 1.34 ± 0.90 m/s, 1.55 ± 0.79 m/s and 1.86 ± 0.75 m/s (P < 0.001), respectively. The Az for differentiating NAFLD from NASH or fibrosis was 0.899 (optimal cut-off value 1.3 m/s; sensitivity 85 %; specificity 83.3 %).
CONCLUSION: The ARFI technique is a useful diagnostic tool for differentiating NAFLD from NASH in asymptomatic patients with morbid obesity.
KEY POINTS : • Acoustic radiation force impulse imaging provides ultrasonic shear wave velocity measurements. • SWV measurements were higher in patients with inflammation or fibrosis than NAFLD. • ARFI differentiates NAFLD from NASH in patients with morbid obesity. • Results suggest that ARFI can detect NASH in asymptomatic morbidly obese patients.
Authors:
F Guzmán-Aroca; M D Frutos-Bernal; A Bas; J A Luján-Mompeán; M Reus; Juan de Dios Berná-Serna; P Parrilla
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Publication Detail:
Type:  Journal Article     Date:  2012-06-01
Journal Detail:
Title:  European radiology     Volume:  22     ISSN:  1432-1084     ISO Abbreviation:  Eur Radiol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-16     Completed Date:  2013-04-02     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  2525-32     Citation Subset:  IM    
Affiliation:
Department of of Radiology, Virgen de la Arrixaca University Hospital, 30120, El Palmar, Murcia, Spain.
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MeSH Terms
Descriptor/Qualifier:
Acoustics
Adult
Bariatric Surgery / methods*
Biopsy
Fatty Liver / complications*,  diagnosis*
Female
Humans
Inflammation
Liver / physiopathology,  ultrasonography
Male
Middle Aged
Obesity, Morbid / complications*
Prospective Studies
ROC Curve
Reference Standards
Reproducibility of Results
Shear Strength
Stress, Mechanical
Ultrasonography / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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