Background: Liver fibrosis induced by non-alcoholic fatty liver disease causes peri-interventional complications in morbidly obese patients. We determined the performance of transient elastography (TE), acoustic radiation force impulse (ARFI) imaging, and enhanced liver fibrosis (ELF) score for fibrosis detection in bariatric patients.
Patients and Methods: 41 patients (median BMI 47 kg/m2) underwent 14-day low-energy diets to improve conditions prior to bariatric surgery (day 0). TE (M and XL probe), ARFI, and ELF score were performed
on days -15 and -1 and compared with intraoperative liver biopsies (NAS staging).
Results: Valid TE and ARFI results at day -15 and -1 were obtained in 49%/88%and 51%/90%of cases, respectively. High skin-to-liver-capsule distances correlated with invalid TE measurements. Fibrosis of liver biopsies was staged as F1 and F3 in n = 40 and n = 1 individuals.
However, variations (median/range at d-15/-1) of TE (4.6/2.6–75 and 6.7/2.9–21.3 kPa) and ARFI (2.1/0.7–3.7 and 2.0/0.7–3.8 m/s) were high and associated with overestimation of fibrosis. The ELF score correctly classified 87.5%of patients.
Conclusion: In bariatric patients, performance of TE and ARFI was poor and did not improve after weight loss. The ELF score correctly classified the majority of cases and should be further evaluated.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa.de:bsz:15-qucosa-189067 |
| Date | 20 November 2015 |
| Creators | Karlas, Thomas, Dietrich, Arne, Peter, Veronica, Wittekind, Christian, Lichtinghagen, Ralf, Garnov, Nikita, Linder, Nicolas, Schaudinn, Alexander, Busse, Harald, Prettin, Christiane, Keim, Volker, Tröltzsch, Michael, Schütz, Tatjana, Wiegand, Johannes |
| Contributors | Universitätsklinikum Leipzig, Integriertes Forschungs- und Behandlungszentrum (IFB) AdipositasErkrankungen, Universitätsklinikum Leipzig, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig, Klinik und Poliklinik für Viszeral-, Transplantations-, Thorax- und Gefäßchirurgie, Universitätsklinikum Leipzig, Institut für Pathologie, Medizinische Hochschule Hannover, Institut für Klinische Chemie, Universitätsklinikum Leipzig, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universität Leipzig, Zentrum für Klinische Studien Leipzig, Public Library of Science, |
| Publisher | Universitätsbibliothek Leipzig |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | doc-type:article |
| Format | application/pdf |
| Source | PLoS one 10(11) : e0141649 |
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