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01-11-2012 | Ultrasound

Detection of non-alcoholic steatohepatitis in patients with morbid obesity before bariatric surgery: preliminary evaluation with acoustic radiation force impulse imaging

Authors: F. Guzmán-Aroca, M. D. Frutos-Bernal, A. Bas, J. A. Luján-Mompeán, M. Reus, Juan de Dios Berná-Serna, P. Parrilla

Published in: European Radiology | Issue 11/2012

Abstract

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.

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Title: Detection of non-alcoholic steatohepatitis in patients with morbid obesity before bariatric surgery: preliminary evaluation with acoustic radiation force impulse imaging
Authors: F. Guzmán-Aroca
M. D. Frutos-Bernal
A. Bas
J. A. Luján-Mompeán
M. Reus
Juan de Dios Berná-Serna
P. Parrilla
Publication date: 01-11-2012
Publisher: Springer-Verlag
Published in: European Radiology / Issue 11/2012
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-012-2505-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Detection of non-alcoholic steatohepatitis in patients with morbid obesity before bariatric surgery: preliminary evaluation with acoustic radiation force impulse imaging

Abstract

Objective

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Key Points

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