Abstract
Ultrasound and magnetic resonance (MR)-based elastography have demonstrated excellent
performance for noninvasive staging of fibrosis in patients with nonalcoholic fatty
liver disease (NAFLD); however, their ability to differentiate isolated fatty liver
from nonalcoholic steatohepatitis (NASH) is unclear. In this review, the authors provide
background on elastography and review the ability of elastography to discriminate
between isolated steatosis and NASH. Studies with available data on the diagnosis
of NASH histology are limited to vibration-controlled transient elastography and MR
elastography. A wide range of optimal cutoffs for the diagnosis of NASH are reported
and likely depend on the prevalence of advanced fibrosis in the study population.
MR elastography has good performance characteristics for identifying patients with
any fibrosis who are at greatest risk of disease-related morbidity. Currently, neither
modality can reliably discriminate NASH from simple steatosis. Novel multiparametric
MR imaging and elastography are emerging and may help detect presence of NASH in the
future.
Keywords
MR elastography - FibroScan - VCTE - nonalcoholic steatohepatitis
