Arteaga Ingrid, Chacón Carla, Martínez-Escudé Alba, Rojano Irene Ruiz, Diez-Fadrique Galadriel, Carmona-Cervelló Meritxell, Torán-Monserrat Pere
Unitat de Suport a la Recerca (USR) Metropolitana Nord, Fundació Institut Universitari d'Investigació en Atenció Primària Jordi Gol i Gurina (IDIAP Jordi Gol), 08303 Mataró, Spain.
Grup de Recerca en Malalties Hepàtiques a l'Atenció Primària (GRemHAp), IDIAP Jordi Gol, USR Metro-Nord, 08303 Mataró, Spain.
Diagnostics (Basel). 2025 Jan 27;15(3):299. doi: 10.3390/diagnostics15030299.
Non-alcoholic fatty liver disease (NAFLD) in the pediatric population has emerged as a significant health concern due to its alarming rise in prevalence. In children, the characteristics of the disease differ from those seen in adults. NAFLD may progress to more severe liver disease in children compared to adults with similar profiles. Liver biopsy remains the gold standard for diagnosis; its invasive nature and high cost limit its use as a first-line tool. Alternatively, magnetic resonance imaging (MRI) techniques, such as magnetic resonance imaging-estimated liver proton density fat fraction (MRI-PDFF), have shown a good correlation with the degree of histological steatosis, although their use is limited by high costs and limited accessibility. Controlled attenuation parameter (CAP), integrated with vibration-controlled transient elastography (VCTE) (FibroScan), is a novel non-invasive, accessible, and effective method for diagnosing hepatic steatosis. In this article, we reviewed the existing literature on the diagnostic accuracy of CAP in pediatric NAFLD. The PubMed and EMBASE databases were searched. Seven relevant studies were identified, conducted in pediatric hospital populations with specific demographic characteristics. Two of these studies compared CAP with liver biopsy, one compared CAP with liver biopsy and MRI-PDFF, and the remaining four compared CAP with MRI. Overall, CAP proved to be accurate in detecting the presence or absence of fatty infiltration, positioning it as a promising tool to simplify the diagnosis of NAFLD in children. However, further studies in larger populations are needed to confirm these findings and facilitate its implementation in routine clinical practice.
由于其患病率惊人地上升，儿童非酒精性脂肪性肝病（NAFLD）已成为一个重大的健康问题。在儿童中，该疾病的特征与成人不同。与具有相似特征的成人相比，NAFLD在儿童中可能进展为更严重的肝病。肝活检仍然是诊断的金标准；其侵入性和高成本限制了它作为一线工具的使用。另外，磁共振成像（MRI）技术，如磁共振成像估计的肝脏质子密度脂肪分数（MRI-PDFF），已显示出与组织学脂肪变性程度有良好的相关性，尽管其使用受到高成本和可及性有限的限制。受控衰减参数（CAP）与振动控制瞬时弹性成像（VCTE）（FibroScan）相结合，是一种诊断肝脂肪变性的新型非侵入性、可及且有效的方法。在本文中，我们回顾了关于CAP在儿童NAFLD诊断准确性的现有文献。检索了PubMed和EMBASE数据库。确定了七项相关研究，这些研究是在具有特定人口统计学特征的儿科医院人群中进行的。其中两项研究将CAP与肝活检进行了比较，一项将CAP与肝活检和MRI-PDFF进行了比较，其余四项将CAP与MRI进行了比较。总体而言，CAP在检测脂肪浸润的有无方面被证明是准确的，使其成为简化儿童NAFLD诊断的一种有前景的工具。然而，需要在更大的人群中进行进一步研究以证实这些发现，并促进其在常规临床实践中的应用。
