US Cannot Be Used to Predict the Presence or Severity of Hepatic Steatosis in Severely Obese Adolescents

Bohte, Anneloes E.; Koot, Bart; Baan-Slootweg, Olga H van der; Rijcken, Tammo H. Pels; Werven, Jochem R. van; Bipat, Shandra; Nederveen, Aart J.; Jansen, Petér L. M.; Benninga, Marc A.; Stoker, Jaap

doi:10.1148/radiol.11111094

Cited by 62 publications

(60 citation statements)

References 28 publications

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“…The study based assessment of liver fat content on MRI, that has been recognized performing better than US for evaluation of liver fat [13] in the general population, as well in obese adolescents [16] and children with NAFLD [14,15] . The overall prevalence of elevated (≥ 9%) liver fat fraction at baseline was 34.8%, that is within the range (32%-40%) estimated in recent studies conducting in obese children and using MRI [4,14,15] .…”

Section: Discussionmentioning

confidence: 99%

“…Children with NAFLD are usually asymptomatic and come to clinical attention because of elevated liver enzymes or fatty liver seen in incidentally observed elevated serum aminotransferases [6] . While concordance between serum aminotransferases and US in identifying fatty liver [12,16,17] may be low, it has been proved for MRI [12,18] . Despite the potential clinical and practical relevance, there is lack of studies in the current literature assessing the relationship of longitudinal change of liver fat content with liver biochemical parameters in pediatric age.…”

Section: Introductionmentioning

confidence: 99%

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Changes of liver fat content and transaminases in obese children after 12-mo nutritional intervention

Verduci

Pozzato²,

Banderali³

et al. 2013

WJH

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AIM: To assess a relationship between longitudinal changes in liver fat content and biochemical parameters in obese children after 1-year nutritional intervention. METHODS:Forty-six obese children, 21 males and 25 females, aged 6-14 years, underwent metabolic measurements, liver ultrasonography (US) and chemicalshift magnetic resonance imaging (MRI) examinations at baseline and after 1-year nutritional intervention. A child was defined obese if her/his body mass index (BMI) was above the age-and sex-adjusted BMI Cole's curve passing through the cut-off of 30 kg/m 2 at 18 years.BMI Z scores were calculated and adjusted for age and gender by using the Cole's LMS-method and Italian reference data. Biochemistry included serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Abdominal US and chemical-shift MRI were performed according to a randomized sequence.The same radiologist performed US by a GE Logiq 9 (General Electric Healthcare Medical Systems, Milwaukee, WI, United States) using a 3.5-MHz convex array transducer. Liver echogenicity was evaluated independently on videotape by 3 radiologists unaware of the child and MRI outcomes, and a consensus was established. Another experienced radiologist, unaware of the child and US data, performed the abdominal chemicalshift MRI with a 1-t system NT-Intera (Philips Medical Systems, Best, The Netherlands) and a phased-array coil. Liver fat fraction (FF) on MRI was judged elevated when greater than 9%. A FF > 18% was considered expressing more severe cases of fatty liver according to Fishbein. A nutritional-behavioral intervention was recommended to promote a normocaloric balanced diet and active lifestyle based on the Italian guidelines for treatment of childhood obesity. RESULTS:Compared to baseline, at the end of intervention children showed lower intakes of energy (mean ± SD: 2549 ± 1238 Kcal vs 1770 ± 622 Kcal, P < 0.0001), total fat (90 ± 47 g vs 52 ± 23 g, P < 0.0001), carbohydrates (356 ± 174 g vs 241 ± 111 g, P = 0.001), and protein (99 ± 48 g vs 75 ± 23 g, P = 0.006) intakes. Prevalence of FF ≥ 9% declined from 34.8% to 8.7% (P < 0.01), with a mean reduction of 7.8% (95%CI: 5.0-10.6). At baseline, FF was associated with liver biochemical parameters (maximum P < 0.001). At the end of the intervention association was found with AST (P = 0.017). Change of FF was associated with change in AST (P = 0.027) and ALT (P = 0.024). Rate of increased liver echogenicity declined from 45.6% to 21.7% (P < 0.0001). Liver echogenicity was associated with ALT at baseline only (P < 0.001). An age-and sexadjusted multiple regression analysis showed that FF 505Verduci E et al . Liver fat in obese childrenSeptember 27, 2013|Volume 5|Issue 9| WJH|www.wjgnet.com change was independently associated with change in serum AST (adjusted regression coefficient 0.348, P = 0.048). CONCLUSION:The results suggest that in obese children longitudinal changes in liver fat content based on MRI may be associated with change in serum transaminases suggesting novelty in mon...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Changes of liver fat content and transaminases in obese children after 12-mo nutritional intervention

Verduci

Pozzato²,

Banderali³

et al. 2013

WJH

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“…After carefully shaving and degreasing the skin with 70% alcohol, transcutaneous US of the liver region was conducted at the 8 th -13 th intercostal spaces of the right flank of the animal. For diagnosis and grading of the severity of HS, standardized transverse and longitudinal views of the right hepatic lobe, including the right kidney, diaphragm, and intestines, as well as the portal vasculature [11] , were obtained.…”

Section: Abdominal Usmentioning

confidence: 99%

Negatif Enerji Dengesiyle Oluşturulmuş Koyun Yağlı Karaciğerinin Ultrasonografik Değerlendirmesi

Yang¹,

Xu²,

Cheng³

et al. 2017

Kafkas Univ Vet Fak Derg

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Fatty liver disease is a common liver disease in humans and animals alike, and macrofauna are considered an ideal model of fatty liver disease for ultrasonography (US)-based diagnostic research. Here, a model of fatty liver disease in lactating thin-tail sheep induced by negative energy balance was developed by restricted feeding. Ultrasonographic images were divided into the following fat classes according to liver triglyceride concentrations (ratio of triglyceride weight to wet liver weight): healthy liver, <2%; mild hepatic steatosis (HS), ≥2% to 5%; moderate HS, ≥5% to 10%; and severe HS, ≥10%. Characteristics of Ultrasonographic images according to HS severity were evaluated. As the results, mild to severe HS was detected by restricted feeding. The sensitivity of 5 MHz for diagnostic differentiation of healthy liver, and mild, moderate, and severe HS were 66.7%, 60.0%, 66.7%, and 82.5%, respectively, with a moderate κ statistic ranging from 0.667 to 0.735 among observers. The sensitivity of 3.5 MHz for diagnosis of healthy liver, and mild, moderate, and severe HS were 69.7%, 60.5%, 81.5%, and 75.4%, respectively, with moderate κ statistics ranging from 0.575 to 0.684 among observers. The sensitivities of 3.5 and 5 MHz for moderate to severe HS reached 97.4% and 98.2%, respectively. In summary, visualization at 3.5 and 5 MHz was ideal for diagnosis of HS except mild cases with established US diagnostic standards. Furthermore, with the established model, newer methods, such as image digitizing analysis, can be used for US-based diagnosis of fatty liver in further investigations. Keywords: Ultrasound, Fatty liver, Sheep, Negative energy balance Negatif Enerji Dengesiyle Oluşturulmuş Koyun Yağlı Karaciğerinin Ultrasonografik Değerlendirmesi ÖzetYağlı karaciğer hastalığı insanlarda ve benzer olarak hayvanlarda yaygın bir karaciğer hastalığı olup, makrofauna yağlı karaciğer hastalığının ultrasonografi (US)-temelli diagnostik araştırmaları için ideal bir modeldir. Bu çalışmada, laktasyondaki ince kuyruklu koyun ırkında negatif enerji dengesi ile yağlı karaciğer hastalığı modeli beslemenin kısıtlaması yoluyla oluşturulmuştur. Ultrasonografik görüntüler karaciğer trigliserid konsantrasyonu (yaş karaciğer ağırlığının trigliserid ağırlığına oranı) baz alınarak yağ sınıflarına ayrılmıştır; sağlıklı karaciğer, <2%; hafif hepatik steatozis (HS), ≥2% ile 5% arası; orta derecede HS, ≥5% ile 10% arası ve şiddetli HS, ≥10%. HS şiddetine göre ultrasonografik görüntülerin özellikleri değerlendirildi. Sonuç olarak kısıtlı besleme ile hafif ve orta derecelerde HS tespit edildi. Sağlıklı, hafif, orta ve şiddetli HS'nin diagnostik ayırımı için 5 MHz'nin hassasiyeti sırasıyla %66.7, %60.0, %66.7 ve %82.5 olarak belirlendi. Gözlemciler arasında ortalama κ istatistik 0.667 ile 0.735 arasında değişim gösterdi. Sağlıklı, hafif, orta ve şiddetli HS'nin diagnostik ayırımı için 3.5 MHz'nin hassasiyeti sırasıyla %69.7, %60.5, %81.5 ve %75.4 olarak belirlendi. Gözlemciler arasında ortalama κ istatistik 0.575 ile 0.684 arasında değiş...

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“…So, objective quantification of steatosis and its differentiation from NASH, mild fibrotic or fatty fibrotic liver are not possible by conventional US alone. Sensitivity and specificity are additionally decreased in very obese children (17). As many other different clinical conditions may also present with fatty liver, differentiation between them should be made only by combining clinical, biochemical, imaging and, finally, histology work ups (10,11,15).…”

Section: Fatty Livermentioning

confidence: 99%

The role of conventional ultrasound in pediatric chronic liver diseases

Kekez¹

2016

Pedaiatr Today

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The aim of this article is to provide an overview of conventional ultrasound in imaging chronic liver diseases in children. The first part describes the normal ultrasound appearance of a child`s liver and the concepts of examination. The further sections present the usual ultrasound findings, the key sonographic points of the most common chronic paediatric liver conditions, and the role of ultrasound in providing diagnostic and prognostic information, detecting complications and supporting reassuring liver biopsy. The limitations of the method are also discussed. Taking all this into account, the interpretation of ultrasound is better in the context of the clinical picture and, in inconclusive cases, followed up with additional imaging and laboratory work up. Conclusion -In conclusion, regardless of the progress made in diagnostic methodology, ultrasound still remains the first, but mostly not the last imaging modality for presumed chronic liver diseases, in daily clinical practice.

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US Cannot Be Used to Predict the Presence or Severity of Hepatic Steatosis in Severely Obese Adolescents

Cited by 62 publications

References 28 publications

Changes of liver fat content and transaminases in obese children after 12-mo nutritional intervention

Changes of liver fat content and transaminases in obese children after 12-mo nutritional intervention

Negatif Enerji Dengesiyle Oluşturulmuş Koyun Yağlı Karaciğerinin Ultrasonografik Değerlendirmesi

The role of conventional ultrasound in pediatric chronic liver diseases

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