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Hepatic artery resistive index as surrogate marker for fibrosis progression in NAFLD patients: A clinical perspective
Ultrasound (US) can reveal the presence of steatosis in non-alcoholic fatty liver disease (NAFLD), but its diagnostic accuracy to reveal signs of fibrosis is low except in advanced stages of disease (e.g. cirrhosis). Current guidelines suggest the use of clinical algorithms, such as the NAFLD fibros...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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SAGE Publications
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5992803/ https://www.ncbi.nlm.nih.gov/pubmed/29873275 http://dx.doi.org/10.1177/2058738418781373 |
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author | Tana, Claudio Schiavone, Cosima Ticinesi, Andrea Lauretani, Fulvio Nouvenne, Antonio Dietrich, Christoph Frank Meschi, Tiziana |
author_facet | Tana, Claudio Schiavone, Cosima Ticinesi, Andrea Lauretani, Fulvio Nouvenne, Antonio Dietrich, Christoph Frank Meschi, Tiziana |
author_sort | Tana, Claudio |
collection | PubMed |
description | Ultrasound (US) can reveal the presence of steatosis in non-alcoholic fatty liver disease (NAFLD), but its diagnostic accuracy to reveal signs of fibrosis is low except in advanced stages of disease (e.g. cirrhosis). Current guidelines suggest the use of clinical algorithms, such as the NAFLD fibrosis score, and elastography to predict the progression of fibrosis, and the integration of elastography improves the detection accuracy of liver stiffness. However, there is a lack of evidence about the correlation between clinical algorithms and conventional US, and elastography is limited by the relative low diffusion, necessity of training, and loss of diagnostic accuracy in patients with high body mass index (BMI), waist circumference, or increased thickness of parietal walls, with consequent significant rates of failure of measurement of liver stiffness. Recently, the measurement of hepatic artery resistive index (HARI) has demonstrated a significant positive correlation with fibrosis degree, as measured with NAFLD fibrosis score, suggesting that the fibrous tissue accumulation may result in increased arterial rigidity and, therefore, in a rise of resistance to flow, and that the different tissue composition of the liver (adipose versus fibrous) can influence HARI differently. These issues should be further investigated because some aspects are still unknown. The limited data currently justify the need of larger, prospective studies aimed at assessing whether HARI correlates with elastography results. In view of their effect on weight loss, serum lipid concentration, and hepatic arterial flow hemodynamics, it could be interesting to evaluate if lifestyle and diet changes can influence significantly HARI values in NAFLD patients. |
format | Online Article Text |
id | pubmed-5992803 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-59928032019-03-08 Hepatic artery resistive index as surrogate marker for fibrosis progression in NAFLD patients: A clinical perspective Tana, Claudio Schiavone, Cosima Ticinesi, Andrea Lauretani, Fulvio Nouvenne, Antonio Dietrich, Christoph Frank Meschi, Tiziana Int J Immunopathol Pharmacol Letter to the Editor Ultrasound (US) can reveal the presence of steatosis in non-alcoholic fatty liver disease (NAFLD), but its diagnostic accuracy to reveal signs of fibrosis is low except in advanced stages of disease (e.g. cirrhosis). Current guidelines suggest the use of clinical algorithms, such as the NAFLD fibrosis score, and elastography to predict the progression of fibrosis, and the integration of elastography improves the detection accuracy of liver stiffness. However, there is a lack of evidence about the correlation between clinical algorithms and conventional US, and elastography is limited by the relative low diffusion, necessity of training, and loss of diagnostic accuracy in patients with high body mass index (BMI), waist circumference, or increased thickness of parietal walls, with consequent significant rates of failure of measurement of liver stiffness. Recently, the measurement of hepatic artery resistive index (HARI) has demonstrated a significant positive correlation with fibrosis degree, as measured with NAFLD fibrosis score, suggesting that the fibrous tissue accumulation may result in increased arterial rigidity and, therefore, in a rise of resistance to flow, and that the different tissue composition of the liver (adipose versus fibrous) can influence HARI differently. These issues should be further investigated because some aspects are still unknown. The limited data currently justify the need of larger, prospective studies aimed at assessing whether HARI correlates with elastography results. In view of their effect on weight loss, serum lipid concentration, and hepatic arterial flow hemodynamics, it could be interesting to evaluate if lifestyle and diet changes can influence significantly HARI values in NAFLD patients. SAGE Publications 2018-06-06 /pmc/articles/PMC5992803/ /pubmed/29873275 http://dx.doi.org/10.1177/2058738418781373 Text en © The Author(s) 2018 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Letter to the Editor Tana, Claudio Schiavone, Cosima Ticinesi, Andrea Lauretani, Fulvio Nouvenne, Antonio Dietrich, Christoph Frank Meschi, Tiziana Hepatic artery resistive index as surrogate marker for fibrosis progression in NAFLD patients: A clinical perspective |
title | Hepatic artery resistive index as surrogate marker for fibrosis
progression in NAFLD patients: A clinical perspective |
title_full | Hepatic artery resistive index as surrogate marker for fibrosis
progression in NAFLD patients: A clinical perspective |
title_fullStr | Hepatic artery resistive index as surrogate marker for fibrosis
progression in NAFLD patients: A clinical perspective |
title_full_unstemmed | Hepatic artery resistive index as surrogate marker for fibrosis
progression in NAFLD patients: A clinical perspective |
title_short | Hepatic artery resistive index as surrogate marker for fibrosis
progression in NAFLD patients: A clinical perspective |
title_sort | hepatic artery resistive index as surrogate marker for fibrosis
progression in nafld patients: a clinical perspective |
topic | Letter to the Editor |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5992803/ https://www.ncbi.nlm.nih.gov/pubmed/29873275 http://dx.doi.org/10.1177/2058738418781373 |
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