Taru Madalina-Gabriela, Neamti Lidia, Taru Vlad, Procopciuc Lucia Maria, Procopet Bogdan, Lupsor-Platon Monica
Hepatology Department, Regional Institute of Gastroenterology and Hepatology "Octavian Fodor", 400162 Cluj-Napoca, Romania.
Faculty of Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
Diagnostics (Basel). 2023 Feb 19;13(4):788. doi: 10.3390/diagnostics13040788.
Non-alcoholic fatty liver disease (NAFLD), and its progressive form, non-alcoholic steatohepatitis (NASH), represent, nowadays, real challenges for the healthcare system. Liver fibrosis is the most important prognostic factor for NAFLD, and advanced fibrosis is associated with higher liver-related mortality rates. Therefore, the key issues in NAFLD are the differentiation of NASH from simple steatosis and identification of advanced hepatic fibrosis. We critically reviewed the ultrasound (US) elastography techniques for the quantitative characterization of fibrosis, steatosis, and inflammation in NAFLD and NASH, with a specific focus on how to differentiate advanced fibrosis in adult patients. Vibration-controlled transient elastography (VCTE) is still the most utilized and validated elastography method for liver fibrosis assessment. The recently developed point shear wave elastography (pSWE) and two-dimensional shear wave elastography (2D-SWE) techniques that use multiparametric approaches could bring essential improvements to diagnosis and risk stratification.
非酒精性脂肪性肝病（NAFLD）及其进展形式非酒精性脂肪性肝炎（NASH）如今已成为医疗系统面临的实际挑战。肝纤维化是非酒精性脂肪性肝病最重要的预后因素，而晚期纤维化与更高的肝脏相关死亡率相关。因此，非酒精性脂肪性肝病的关键问题在于将非酒精性脂肪性肝炎与单纯性脂肪变性区分开来，并识别晚期肝纤维化。我们严格审查了用于定量表征非酒精性脂肪性肝病和非酒精性脂肪性肝炎中的纤维化、脂肪变性和炎症的超声（US）弹性成像技术，特别关注如何区分成年患者的晚期纤维化。振动控制瞬时弹性成像（VCTE）仍然是用于肝纤维化评估的最常用且经过验证的弹性成像方法。最近开发的使用多参数方法的点剪切波弹性成像（pSWE）和二维剪切波弹性成像（2D-SWE）技术可能会给诊断和风险分层带来实质性改善。
