Evaluation of fatty liver with grey scale 2D ultrasonography and ultrasound elastography and co-relation with lipid profile in adult patient in the state of Chhattisgarh attending Dr. Bhim Rao Ambedkar memorial hospital tertiary care centre Raipur

Authors

  • Ashwini Narayan Chaudhari Pandit Deendayal Upadhyay Memorial Health Science and Ayush University of Chhattisgarh, Raipur, Chhattisgarh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20232636

Keywords:

Ultrasound, Elastography, Liver stiffness, Fatty liver, NAFLD

Abstract

Background: Several noninvasive imaging techniques have been introduced for the assessment of liver fibrosis. Among these techniques real-time Point shear wave elastography has become a promising imaging modality for the measurement of liver stiffness. The advantage of this technique is that the elasticity displayed using a B-mode image, also a quantitative estimation of liver stiffness is performed. The present study evaluates the fatty liver in patients above 18 years age with grey scale 2D ultrasonography and ultrasound elastography and also study the correlation with lipid profile in patients attending Dr B.R.A.M hospital tertiary care center Raipur, Chhattisgarh.

Methods: This was a hospital based observational study conducted in Department of Radio-diagnosis, Dr BRAM Hospital and Pt JNM Medical College, Raipur (C.G). A sample of 198 patient above 18-year age with fatty liver were taken. Grading and quantification of fatty liver was also done by Shear wave elastography. A p-value <0.05 was considered statistically significant.

Results: Mean age of study subjects was 48.47±15.21 years and 52.02% were female. 2D ultrasound technique diagnosed 75.25% grade-1 and 24.24% were in grade-II. Elastography technique diagnosed 57.58% with dysfunction (F1) liver stiffness, 28.28% fibrosis present (F2 or F3) and 13.64% normal. Increasing liver stiffness stages was significantly associated with increasing levels of serum VLDL (p=0.04).

Conclusions: Ultrasound used in conjunction with elastography has shown utility in diagnosing and follow up of fatty liver patients. Liver stiffness was significantly associated with increasing levels of serum VLDL.

References

Ratziu V, Bellentani S, Cortez-Pinto H, Day C, Marchesini G. A position statement on NAFLD/NASH based on the EASL 2009 special conference. J Hepatol. 2010;53(2):372-84.

Szczepaniak LS, Bannas P, Kramer H, Hernando D, Agni R, Cunningham AM, Mandal R, Motosugi U, Sharma SD, Munoz del Rio A, Fernandez L, Reeder SB. Quantitative magnetic resonance imaging of hepatic steatosis: Validation in ex vivo human livers. Hepatology. 2015 Nov;62(5):1444-55.

Marchesini G, Brizi M, Morselli-Labate AM, Bianchi G, Bugianesi E, McCullough AJ, Forlani G, Melchionda N. Association of nonalcoholic fatty liver disease with insulin resistance. Am J Med. 1999; 107(5):450-5.

Marceau P, Biron S, Hould FS, Marceau S, Simard S, Thung SN, Kral JG. Liver pathology and the metabolic syndrome X in severe obesity. J Clin Endocrinol Metab. 1999;84(5):1513-7.

Marchesini G, Brizi M, Bianchi G, Tomassetti S, Bugianesi E, Lenzi M, McCullough AJ, Natale S, Forlani G, Melchionda N. Nonalcoholic fatty liver disease: a feature of the metabolic syndrome. Diabetes. 2001;50(8):1844-50.

Bugianesi E. Third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation. 2011;106:314-21.

Nohara A, Kobayashi J, Mabuchi H. Retinoid X receptor heterodimer variants and cardiovascular risk factors. J Atheroscler Thromb. 2009;16(4):303-18.

Angulo P. Medical progress: nonalcoholic fatty liver disease. New Eng J Med. 2002:346(16):1221-31.

Edmison J, McCullough AJ. Pathogenesis of non-alcoholic steatohepatitis: human data. Clin Liver Dis. 2007;11(1):75-104.

Wieckowska A, Feldstein AE. Diagnosis of nonalcoholic fatty liver disease: invasive versus noninvasive. Semin Liver Dis. 2008;28(4):386-95.

Dhyani M, Anvari A, Samir AE. Ultrasound elastography: liver. Abdom Imaging. 2015;40(4):698-708.

Chen J, Talwalkar JA, Yin M. Early detection of nonalcoholic steatohepatitis in patients with nonalcoholic fatty liver disease by using MR elastography. Radiology. 2011;259:749-56.

Kalra S, Vithalani M, Gulati G, Kulkarni CM, Kadam Y, Pallivathukkal J, et al. Study of prevalence of nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes patients in India (SPRINT). J Assoc Physicians India. 2013;61(7):448-53.

Gupta N, Raj K, Chandra R. Relationship between grey scale sonographic grades of fatty liver and shear wave elastographic values: an observational study. Int J Res Med Sci. 2019;7(2):526-31.

Mahaling DU, Madole M, Bika AJ. Comparison of lipid profile in different grades of non-alcoholic fatty liver disease diagnosed on ultrasound. Asian Pacific J Trop Biomed. 2019;3(11):907-12.

Li YY, Wang XM, Zhang YX, Ou GC. Ultrasonic elastography in clinical quantitative assessment of fatty liver. World J Gastroenterol. 2010;16(37):4733-7.

Constantinescu C, SĂndulescu L, SĂftoiu A. The Role of Elastography in Non-Alcoholic Fatty Liver Disease. Curr Health Sci J. 2020;46(3):255-69.

Kamali L, Adibi A, Ebrahimian S, Jafari F, Sharifi M. Diagnostic Performance of Ultrasonography in Detecting Fatty Liver Disease in Comparison with Fibroscan in People Suspected of Fatty Liver. Adv Biomed Res. 2019;8:69

Macabuag-Oliva AM, Thiele M, Madsen BS, Hansen JF, Detlefsen S, Antonsen S, et al. Accuracy of the Enhanced Liver Fibrosis Test vs FibroTest, Elastography, and Indirect Markers in Detection of Advanced Fibrosis in Patients With Alcoholic Liver Disease. Gastroenterology. 2018;154(5):1369-1379.

Najeeb Q, Sameer SA, Ruqaya A, Sajad H. Association of lipid profile and liver enzymes among non-alcoholic fatty liver disease patients attending a tertiary care hospital in northern Indian. Int J Current Res. 2015;7(4):14348-52.

Downloads

Published

2023-08-28

Issue

Section

Original Research Articles