Woodard Jordan S, Velji-Ibrahim Jena, Alden Jay, Abrams Gary A
University of Kentucky Healthcare, Department of Medicine, Lexington, Kentucky, USA.
Prisma Health-Upstate, Department of Medicine, Greenville, South Carolina, USA.
Case Rep Gastrointest Med. 2024 Oct 28;2024:7938701. doi: 10.1155/2024/7938701. eCollection 2024.
Vibration-controlled transient elastography (VCTE) is used for the noninvasive assessment of liver fibrosis. We present a case of significant weight loss over 1 year, resulting in a marked improvement in liver stiffness suggesting a decrease in liver fibrosis from stage 4 (cirrhosis) to stage 2 (moderate fibrosis) notably without a change in the grade of hepatic steatosis. The improvement in two stages of fibrosis over this short time frame is due to the overestimation of liver stiffness in a subject with class 3 obesity and not due to the resolution of fibrosis. Therefore, this case highlights that BMI, due to excess subcutaneous abdominal adipose tissue and not intrahepatic lipid accumulation, can cause a significant overestimation of liver fibrosis with VCTE.
振动控制瞬时弹性成像（VCTE）用于肝纤维化的无创评估。我们报告一例在1年多时间内体重显著减轻的病例，结果显示肝硬度明显改善，提示肝纤维化从4期（肝硬化）降至2期（中度纤维化），显著的是肝脂肪变性分级未发生变化。在如此短的时间内纤维化两个阶段的改善是由于3级肥胖患者肝硬度的高估，而非纤维化的消退。因此，该病例强调，由于腹部皮下脂肪组织过多而非肝内脂质蓄积导致的体重指数（BMI），可导致VCTE对肝纤维化的显著高估。
