Copyright
©The Author(s) 2020.
World J Gastroenterol. Jul 7, 2020; 26(25): 3528-3541
Published online Jul 7, 2020. doi: 10.3748/wjg.v26.i25.3528
Published online Jul 7, 2020. doi: 10.3748/wjg.v26.i25.3528
Diagnostic Tests | Advantages | Limitations |
Liver enzymes and other blood tests for fibrosis | ||
Platelet count; APRI; AST; ALT; AST/ALT ratio; Hyaluronic acid; ELF; Hepascore; FibroSpect; FibroTest/FibroSure | Simple and easy; AST/ALT of > 1 is predictive of fibrosis; ELF can predict stage of fibrosis and outcomes | AST and ALT can be normal in some patients with NAFLD; ELF is not widely available; Some tests initially developed for HCV; Limited published data on external validation |
Radiology | ||
Ultrasonography | Easily available; Safe; Overall scanning of abdominal organs | Cannot detect mild degree of steatosis (< 30% of hepatocytes); Does not distinguish between steatosis and NASH; Operator dependent |
MRI | More sensitive than ultrasonography | Cost and availability; Does not distinguish between steatosis and NASH |
Transient; Elastography | Can detect fibrosis | Cost and availability |
MRE | Can detect fibrosis and MRI-PDFF can quantify steatosis | Cost and availability |
Fibrosis scoring systems | ||
NAFLD fibrosis score (NFS), Fibro Meter Fibrosis-4 (FIB-4) | Allow a more targeted use of liver biopsy by reliably excluding advanced fibrosis in a high proportion of NAFLD patients; Potentially predict liver-related and cardiovascular complications and death | Significant number with indeterminate scores; Limited external validation in NASH |
Liver biopsy | Gold standard for diagnosis of NAFLD and NASH; Allows staging of the disease | Invasive; Associated with complications – pain, intraperitoneal bleeding; Cost |
- Citation: Sanai FM, Abaalkhail F, Hasan F, Farooqi MH, Nahdi NA, Younossi ZM. Management of nonalcoholic fatty liver disease in the Middle East. World J Gastroenterol 2020; 26(25): 3528-3541
- URL: https://www.wjgnet.com/1007-9327/full/v26/i25/3528.htm
- DOI: https://dx.doi.org/10.3748/wjg.v26.i25.3528