Globally, there is an increasing incidence of non-alcoholic fatty liver disease (NAFLD), a potential cause of chronic liver disease. NAFLD may result in non-alcoholic steatohepatitis (NASH) which can develop into end stage liver disease. Because of the increasing incidence of fatty liver disease it is critically important to improve our ability to diagnose the spectrum of NAFLD/NASH and its clinical pathways.
The gold standard for assessing the degree of hepatic steatosis is biopsy, however the cost, patient intolerance, risk factors, processing artefacts and the small amount of tissue procured during biopsy may not reflect the global degree of fatty infiltration. Magnetic Resonance imaging (MRI) techniques show promise for assessment of steatosis but are more expensive and resource intensive than ultrasound techniques.
Many novel on cart ultrasound tools are being made available for the assessment of hepatic parenchyma during an ultrasound examination ñ these include Attenuation Index (ATI), Liver-Kidney Ratio and Shear Wave dispersion (SWD). The echosens FibroscanÆ unit utilises a tool ìControlled Attenuation Parameter (CAP)î. CAP estimates the degree of fatty infiltration of the liver by producing a resultant dB/cm/Hz attenuation coefficient.
This talk looks at the preliminary evaluation of some of these tools and their potential role.