Abstract

Introduce and aim: Incidence of obesity and hepatic steatosis is increasing worldwide. Almost 25% of western population suffers from non alcoholic fatty liver disease (NAFLD). Aim of this study is to determine accuracy of different radiologic methods (US, CT and MRI) in diagnostic of nonalcoholic steatohepatitis (NASH) in patients with chronic cryptogenic hepatitis and therefore avoid unnecessary biopsies in cases of simple steatosis. Earlier studies gave us different results and haven’t answered the question how to distinguish NASH from simple steatosis. Ultrasound (US), computed tomography (CT) and magnetic resonance (MRI) can detect steatosis with great sensitivity level, but not NASH. Patients and methods: Study included one hundred patients of both sex (46 women and 54 men) with mean age 38.6, and with defined certain biochemical, antropometric and hormone biomarkers. All these patients underwent liver biopsy and US, CT and MRI exam, NASH is staged by NASH activity score (NAS) from 1 to 8. Results are compared to patohistologic finding as relevant method. Results: These results showed us that 81% of patients (n=81) had NAFLD (minimal stage at least), and 32 (32%) had nonalcoholic steatohepatitis (NASH). US specifiy and sensitivity are 94.7% and 79%; PPV is 98.4% and NPV is 51.4%. CT specificy and sensitivity are 100% and 72.5% with PPV and NPV are 100% and 46.3%. MRI specificy and sensitivity are 100% and 70% with PPV and NPV are 100% and 44.2%. Conclusion: radiological methods are high useful only in cases of steatosis grade 2 or 3 not in mild grade. They can’t distinguish each form of NAFLD like NASH. There are exist significant differences among radiologists in estimation of steatosis.

Key words: computed tomography (CT); cryptogenic hepatitis; nonalcoholic liver disease (NAFLD); nonalcoholic steatohepatitis NASH); magnetic resonance imaging (MRI); ultrasound (US).