Non-alcoholic fatty liver disease other imaging findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Parth Vikram Singh, MBBS
Overview
There are no other imaging findings associated with non-alcoholic fatty liver disease.
Liver stiffness measurement (LSM) by elastography
Vibration-controlled transient elastography is used to noninvasively measure liver stiffness and is commonly used after FIB-4 testing in patients at increased risk for advanced fibrosis. A liver stiffness measurement greater than 8.0 kPa should prompt referral to a hepatologist for further evaluation.
Two-dimensional shear wave elastography [SWE]) can estimate liver stiffness measurements: "LS of 8 and 12.5 kPa represent generally accepted cut-off values for F3 and F4 fibrosis. LS highly correlates with portal pressure, and esophageal varices are likely at values >20 kPa."[1]
- LS of 8 suggests F3 fibrosis
- LS of 12.5 kPa suggests F4 fibrosis
A more recent study suggests lower cutoffs[2]:
- LS of 6 suggests F2 fibrosis
- LS of 7 suggests F3 fibrosis
- LS of 11 kPa suggests F4 fibrosis
The FibroScan can measure LSM by SWE
Magnetic resonance elastography
Magnetic resonance elastography (MRE) may be more accurate than elastography[3]
Hepatic steatosis
Hepattic steatosis can be measured with the Controlled attenuation parameter (CAP).[4][2][5]
The controlled attenuation parameter measures attenuation of ultrasound waves through the liver and is usually performed with vibration-controlled transient elastography. A controlled attenuation parameter value of 248 dB/m or greater is considered diagnostic for hepatic steatosis, and higher values indicate more severe steatosis.
Compared with conventional ultrasonography, controlled attenuation parameter has similar sensitivity and slightly higher specificity, approximately 90%, for detecting hepatic steatosis.
Other imaging
CT scan: "≤ 40 Hounsfield units indicating > 30% hepatic steatosis"[6].
References
- ↑ Mueller S, Sandrin L (2010). "Liver stiffness: a novel parameter for the diagnosis of liver disease". Hepat Med. 2: 49–67. doi:10.2147/hmer.s7394. PMC 3846375. PMID 24367208.
- ↑ 2.0 2.1 Eddowes PJ, Sasso M, Allison M, Tsochatzis E, Anstee QM, Sheridan D; et al. (2019). "Accuracy of FibroScan Controlled Attenuation Parameter and Liver Stiffness Measurement in Assessing Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease". Gastroenterology. 156 (6): 1717–1730. doi:10.1053/j.gastro.2019.01.042. PMID 30689971.
- ↑ Singh S, Venkatesh SK, Wang Z, Miller FH, Motosugi U, Low RN; et al. (2015). "Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: a systematic review and meta-analysis of individual participant data". Clin Gastroenterol Hepatol. 13 (3): 440–451.e6. doi:10.1016/j.cgh.2014.09.046. PMC 4333001. PMID 25305349.
- ↑ Petroff D, Blank V, Newsome PN, Voican CS, Thiele M; et al. (2021). "Assessment of hepatic steatosis by controlled attenuation parameter using the M and XL probes: an individual patient data meta-analysis". Lancet Gastroenterol Hepatol. 6 (3): 185–198. doi:10.1016/S2468-1253(20)30357-5. PMID 33460567 Check
|pmid=value (help). - ↑ Tilg H, Petta S, Stefan N, Targher G (January 2026). "Metabolic Dysfunction-Associated Steatotic Liver Disease in Adults: A Review". JAMA. 335 (2): 163–174. doi:10.1001/jama.2025.19615. PMID 41212550 Check
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