BACKGROUND: Differentiating steatosis from NASH is key in deciding treatment and follow-up schedules. We hypothesized that sonographic grading of steatosis willcorrelate with metabolic and pathologic changes of NASH.METHODS: Fifty-three non-consecutive patients had a semi-quantitative evaluation of hepatic steatosis through ultrasonographic Fatty Liver Indicator (US-FLI) justprior to liver biopsy. All biopsies demonstrated NAFLD. US-FLI is a new scoring system ranging 2-8 based on the intensity of liver/kidney contrast, posterior attenuation of ultrasound beam, vessel blurring, difficult visualization of gallbladder wall, difficult visualization of the diaphragm and areas of focalsparing. NAFLD is diagnosed by the minimum score ≥2. Ultrasonographic findings were correlated with metabolic and histological data. Inter-observer US-FLI scoreagreement, evaluated by three different operators in 31 consecutive patients with steatosis, showed "almost perfect/substantial" agreement (P < 0.001).RESULTS: US-FLI showed a positive correlation with HOMA, insulin, uric acid, ferritin, ALT and bilirubin and was associated with steatosis extent assessed histologically and histological features of NASH, except for fibrosis. US-FLI was an independent predictor of NASH (OR 2.236; P = 0.007) and a US-FLI < 4 had ahigh negative predictive value (94%) in ruling out the diagnosis of severe NASH according to Kleiner's criteria.CONCLUSION: Data confirm the hypothesis that US-FLI significantly correlates with metabolic derangements and individual pathologic criteria for NASH and may betterselect patients for liver biopsy.

Ultrasonographic fatty liver indicator, a novel score which rules out NASH and is correlated with metabolic parameters in NAFLD / Ballestri, Stefano; A., Lonardo; Romagnoli, Dante; Carulli, Lucia; L., Losi; Cp, Day; Loria, Paola. - In: LIVER INTERNATIONAL. - ISSN 1478-3223. - STAMPA. - 32:8(2012), pp. 1242-1252. [10.1111/j.1478-3231.2012.02804.x]

Ultrasonographic fatty liver indicator, a novel score which rules out NASH and is correlated with metabolic parameters in NAFLD.

BALLESTRI, Stefano;ROMAGNOLI, Dante;CARULLI, Lucia;LORIA, Paola
2012

Abstract

BACKGROUND: Differentiating steatosis from NASH is key in deciding treatment and follow-up schedules. We hypothesized that sonographic grading of steatosis willcorrelate with metabolic and pathologic changes of NASH.METHODS: Fifty-three non-consecutive patients had a semi-quantitative evaluation of hepatic steatosis through ultrasonographic Fatty Liver Indicator (US-FLI) justprior to liver biopsy. All biopsies demonstrated NAFLD. US-FLI is a new scoring system ranging 2-8 based on the intensity of liver/kidney contrast, posterior attenuation of ultrasound beam, vessel blurring, difficult visualization of gallbladder wall, difficult visualization of the diaphragm and areas of focalsparing. NAFLD is diagnosed by the minimum score ≥2. Ultrasonographic findings were correlated with metabolic and histological data. Inter-observer US-FLI scoreagreement, evaluated by three different operators in 31 consecutive patients with steatosis, showed "almost perfect/substantial" agreement (P < 0.001).RESULTS: US-FLI showed a positive correlation with HOMA, insulin, uric acid, ferritin, ALT and bilirubin and was associated with steatosis extent assessed histologically and histological features of NASH, except for fibrosis. US-FLI was an independent predictor of NASH (OR 2.236; P = 0.007) and a US-FLI < 4 had ahigh negative predictive value (94%) in ruling out the diagnosis of severe NASH according to Kleiner's criteria.CONCLUSION: Data confirm the hypothesis that US-FLI significantly correlates with metabolic derangements and individual pathologic criteria for NASH and may betterselect patients for liver biopsy.
2012
32
8
1242
1252
Ultrasonographic fatty liver indicator, a novel score which rules out NASH and is correlated with metabolic parameters in NAFLD / Ballestri, Stefano; A., Lonardo; Romagnoli, Dante; Carulli, Lucia; L., Losi; Cp, Day; Loria, Paola. - In: LIVER INTERNATIONAL. - ISSN 1478-3223. - STAMPA. - 32:8(2012), pp. 1242-1252. [10.1111/j.1478-3231.2012.02804.x]
Ballestri, Stefano; A., Lonardo; Romagnoli, Dante; Carulli, Lucia; L., Losi; Cp, Day; Loria, Paola
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/760851
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