Diagnostic performance of Fibroscan and computed tomography in 322 normal alanine aminotransferase non-obese non-alcoholic fatty liver disease patients diagnosed by ultrasound

Aims of the study: To compare the the evaluation of various noninvasive examination include ultrasound, Fibroscan and computed tomography(CT) in normal alanine aminotransferase (ALT) non-obese patients, to analyze the consistency and advantages among these noninvasive examination in non-alcoholic fatty liver disease (NAFLD) patients..

Methods used to conduct the study: 322 cases of non-obese NAFLD patients (BMI < 25 kg/m2) with normal ALT were enrolled. All patients were diagnosed with fatty liver by abdominal ultrasonography. Meanwhile, Computed tomography and Fibroscan were used to evaluate the existence and severity of fatty liver.

Results of the study: 47.52 % and 67.70 % patients who diagnosed as NAFLD by ultrasound were unable to be diagnosed with fatty liver in accordance with the standard of controlled attenuation parameter (CAP) value by fibroscan and liver/spleen density ratio(L/S ratio) by CT.The evaluation of NAFLD by CAP standard were influenced by several factors ,while only age and Triglyceride(TG) may affect the judgment of fatty liver when CT was used. Liver stiffness measurement(LSM) affects the diagnostic coincidence rate of Fibroscan,CT and ultrasound. Statistical difference could be found among different LSM groups in the severity of NAFLD evaluated by Fibroscan and CT.

Conclusions drawn from the study and clinical implications: There is a discrepancy in the evaluation NAFLD by fibroscan, CT and ultrasound. LSM may affect the diagnostic coincidence rate of Fibroscan ,CT and ultrasound. Non-invasive assessment model including multiple clinical data and image results should be investigated in evaluating the degree of NAFLD. Interpretation of the diagnostic results about Fibroscan, CT and ultrasound in the evaluation of NAFLD should take into account the specific clinical data of each patient.