Modern Possibilities of Imaging Diagnosis Methods in Assessing the Severity of Fatty Hepatosis in Non-Alcoholic Fatty Liver Disease (Clinical Case)

Purpose: To estimate the potential of imaging methods in the diagnosis of non-alcoholic fatty liver disease (NAFLD) based on the example of a clinical case.

Material and methods: A 42 years-old man with suspected of NAFLD, by the clinical and laboratory tests results, underwent a quantitative assessment of fatty hepatosis using radiodiagnosis imaging methods. We used US “liver protocol” with attenuation imaging technique (ATI), shear wave elastography (SWE), shear wave dispersion imaging (SWD), computed tomography (CT) with quantitative and qualitative assessment using the liver-spleen index (CT_L-S); MRI with application that provides volumetric whole-liver fat fraction (FF) measurements by proton density (PDFF), on the basis of IDEAL IQ program. The morphological verification of liver biopsy was also performed.

Results: All imaging method used in this clinical case showed severe degree of fatty hepathosis, that correlated with biopsy of liver. In repeated studies, on the background of treatment, the quantitative indicators of all imaging methods had a similar dynamics of reduction of the degree of fatty hepatosis.

Conclusion: The clinical case of verified acute steatohepatitis shows the possibilities of its diagnostics by means of the radiation modalities. We used US with ATI, SWE и SWD, CT with CT_L-S, MRI with FF that demonstrated high diagnostic efficiency for determination fatty hepatosis and the possibility of its quantification. These technologies are suitable for widespread implementation into clinical practice providing good diagnostic accuracy. CT associated with higher doses of radiation is not considered to be the basic method of choice for diagnosing NAFLD, but still may provide a physician with necessary information to determine further treatment strategy.