Noninvasive imaging assessment of non-alcoholic fatty liver disease: Focus on liver scintigraphy

Tovo, Cristiane Valle; Mattos, Ângelo Zambam de; Coral, Gabriela Perdomo; Branco, Fernanda; Suwa, Eiji

doi:10.3748/wjg.v21.i15.4432

Cited by 8 publications

(9 citation statements)

References 71 publications

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“…Unlike abdominal ultrasound, MRI exhibits high sensitivity and specificity for paediatric NAFLD and is able to differentiate, even in severely obese patients, between simple steatosis and NASH [ 17 , 20 ]. It is also able to quantify the distribution and severity of even mild steatosis and fibrosis throughout the entire liver and with moderate to strong correlation with histological grading in children and adults [ 28 , 120 , 121 ]. However, the relatively high cost of MRI, as well as the need for sedation in young children prohibits widespread use in clinical practice and, as such, it remains primarily a research tool.…”

Section: Making the Diagnosismentioning

confidence: 99%

“…While Computerised Tomography (CT) offers greater sensitivity than abdominal ultrasound in detecting the presence and extent of hepatic fat accumulation in NAFLD, the high radiation exposure it encumbers prohibits routine use in young children [ 20 , 121 ]. Furthermore, it also lacks the sensitivity required to detect mild steatosis and small changes in fat content over time.…”

Section: Making the Diagnosismentioning

confidence: 99%

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A Guide to Non-Alcoholic Fatty Liver Disease in Childhood and Adolescence

Temple

Cordero

et al. 2016

IJMS

134

126

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Non-Alcoholic Fatty Liver Disease (NAFLD) is now the most prevalent form of chronic liver disease, affecting 10%–20% of the general paediatric population. Within the next 10 years it is expected to become the leading cause of liver pathology, liver failure and indication for liver transplantation in childhood and adolescence in the Western world. While our understanding of the pathophysiological mechanisms underlying this disease remains limited, it is thought to be the hepatic manifestation of more widespread metabolic dysfunction and is strongly associated with a number of metabolic risk factors, including insulin resistance, dyslipidaemia, cardiovascular disease and, most significantly, obesity. Despite this, ”paediatric” NAFLD remains under-studied, under-recognised and, potentially, undermanaged. This article will explore and evaluate our current understanding of NAFLD in childhood and adolescence and how it differs from adult NAFLD, in terms of its epidemiology, pathophysiology, natural history, diagnosis and clinical management. Given the current absence of definitive radiological and histopathological diagnostic tests, maintenance of a high clinical suspicion by all members of the multidisciplinary team in primary and specialist care settings remains the most potent of diagnostic tools, enabling early diagnosis and appropriate therapeutic intervention.

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Section: Making the Diagnosismentioning

confidence: 99%

Section: Making the Diagnosismentioning

confidence: 99%

A Guide to Non-Alcoholic Fatty Liver Disease in Childhood and Adolescence

Temple

Cordero

et al. 2016

IJMS

134

126

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“…Facing to limitations of this invasive technique in current use, a number of experimental biomarkers have been developed in order to predict the degree of liver fibrosis[19]. Moreover, as a promising method for evaluation of patients with NAFLD, nuclear medicine through liver scintigraphy has recently been proposed[20]. …”

Section: Discussionmentioning

confidence: 99%

Bibliometric analysis of top 100 cited articles in nonalcoholic fatty liver disease research

Zhang¹,

Qin²,

Wang³

et al. 2016

WJH

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AIMTo identify and assess the research situation of top 100 cited articles in nonalcoholic fatty liver disease (NAFLD).METHODSThe global scientific research articles in the Science Citation Index-Expanded relevant to NAFLD were retrieved and listed according to their citation times from the most to the least. The 100 most frequently cited original articles were selected to systematically evaluate their bibliometric parameters including times cited, publication year, journals, subject categories, and the highly related concepts of NAFLD, which reflected the history and current situation, publication distribution of leading countries and institutes as well as the research hotspots of NAFLD.RESULTSTop 100 cited articles in NAFLD were published from 1965 to 2015 with a citation ranging of 227 to 2151 times since publication, in which the United States was the most predominant country and Mayo Clin was the most productive institution. The majority of the top 100 cited articles were concentrated in SCI subject category of Gastroenterology and Hepatology. Hepatology and Gastroenterology is the top journal that published over half 100 top-cited articles. The significant peak of top cited articles present in the first half of the 2000s while the highest mean number of citation presents in first half of the 1980s. In addition, concepts related to pathology characteristics, epidemiology and medicalization, metabolic syndrome and its combination of symptoms including insulin resistance, biomarkers of lipid metabolism and obesity are listed as the highly related concepts.CONCLUSIONThe 100 top-cited articles marked with the leading countries, institutions, journals, hotspots and development trend in NAFLD field that could provide the foundation for further investigations.

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“…Previous reports have shown unenhanced CT images to be useful for predicting the degree of fatty infiltrations in the liver parenchyma (7, 8, 9, 10, 11, 12, 13). Steatosis results in decreased attenuation of the liver, which can be measured in Hounsfield units (HUs).…”

Section: Discussionmentioning

confidence: 99%

Fatty liver formation in fulminant type 1 diabetes

Matsuo¹,

Ushiroda²

2016

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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SummaryA 32-year-old woman presented with 3days of epigastric pain and was admitted to our hospital (day 3 of disease). We diagnosed acute pancreatitis based on epigastric abdominal pain, hyperamylasemia, and an inflammatory reaction of withdrawn blood, pancreatic enlargement, and so on. Her condition improved with treatment; however, on day 8, she had decreased level of consciousness. Laboratory results led to a diagnosis of fulminant type 1 diabetes mellitus (FT1DM) with concomitant diabetic ketoacidosis. Insulin therapy improved her blood glucose levels as well as her symptoms. Fatty liver with liver dysfunction was observed on day 14, which improved by day 24. Blood levels of free fatty acids (FFAs) increased rapidly from 440μEq/L (normal range: 140–850μEq/L) on day 4 to 2097μEq/L on days 7–8 (onset of FT1DM) and subsequently decreased to 246μEq/L at the onset of fatty liver. The rapid decrease in insulin at the onset of FT1DM likely freed fatty acids derived from triglycerides in peripheral adipocytes into the bloodstream. Insulin therapy rapidly transferred FFAs from the periphery to the liver. In addition, insulin promotes the de novo synthesis of triglycerides in the liver, using newly acquired FFAs as substrates. At the same time, inhibitory effects of insulin on VLDL secretion outside of the liver promote the accumulation of triglycerides in the liver, leading to fatty liver. We describe the process by which liver dysfunction and severe fatty liver occurs after the onset of FT1DM, from the perspective of disturbed fatty acid metabolism.Learning pointsFT1DM is rare but should be considered in patients with pancreatitis and a decreased level of consciousness.Fatty liver should be considered in patients with FT1DM when liver dysfunction is observed.Insulin is involved in mechanisms that promote fatty liver formation.Pathophysiological changes in fatty acid metabolism may provide clues on lipid metabolism in the early phases of FT1DM.

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Noninvasive imaging assessment of non-alcoholic fatty liver disease: Focus on liver scintigraphy

Cited by 8 publications

References 71 publications

A Guide to Non-Alcoholic Fatty Liver Disease in Childhood and Adolescence

A Guide to Non-Alcoholic Fatty Liver Disease in Childhood and Adolescence

Bibliometric analysis of top 100 cited articles in nonalcoholic fatty liver disease research

Fatty liver formation in fulminant type 1 diabetes

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