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Review
. 2015 Apr 18;7(5):769-76.
doi: 10.4254/wjh.v7.i5.769.

Importance of imaging and recent developments in diagnosis of nonalcoholic fatty liver disease

Mustafa Koplay  1 , Mesut Sivri  1 , Hasan Erdogan  1 , Alaaddin Nayman  1
Affiliations
Review

Importance of imaging and recent developments in diagnosis of nonalcoholic fatty liver disease

Mustafa Koplay et al. World J Hepatol. .

Abstract

Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease and is a major public health problem worldwide. It is a spectrum that includes simple steatosis, nonalcoholic steatohepatitis (NASH), fibrosis and cirrhosis. Recently, NAFLD prevalence in children and adolescents has increased too. The increasing prevalence has resulted in NASH-related chronic liver disease. Therefore, early diagnosis and treatment is quite important. Although liver biopsy is still the gold standard for diagnosis and staging of NAFLD, particularly for the diagnosis of NASH, imaging methods such as ultrasonography, computed tomography, magnetic resonance imaging with chemical shift imaging and especially magnetic resonance spectroscopy and elastography have been increasingly approved as noninvasive alternative methods. The aim of this review is to analyze the diagnostic accuracy and limitations of the imaging methods and recent developments in the diagnosis of NAFLD.

Keywords: Elastography; Imaging methods; Magnetic resonance spectroscopy; Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis.

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Figures

Figure 1
Figure 1
Ultrasonographic images show the hepatosteatosis stages. A: Grade 1: mild fatty liver; B: Grade 2: moderate fatty liver; C: Grade 3: severe fatty liver.
Figure 2
Figure 2
Computed tomography evaluation of fatty liver using a liver-to-spleen attenuation difference with unenhanced computed tomography. A: Diffuse fatty infiltration of liver with attenuation much lower than the spleen on visual analysis; B: Multiple regions-of-interest (white circles, ROIs) show mean hepatic attenuation (25 HU) and splenic attenuation (51 HU) with -26 HU liver-to-spleen attenuation difference, pointing to moderate-to-severe hepatosteatosis.
Figure 3
Figure 3
Magnetic resonance imaging evaluation of fatty liver using chemical shift imaging. A: In-phase image; B: Out-of-phase image. When out-of-phase image is compared with in-phase images, it shows the signal intensity decrease.
Figure 4
Figure 4
Magnetic resonance spectroscopy image shows a lipid peak in a case of grade 3 hepatosteatosis.
See this image and copyright information in PMC

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