Work-up for Incidentally Detected NAFLD: How Far is It Worth?

Saurabh Mishra, Harish Bhujade, Amna Subhan Butt, Lubna Kamani, Madhumita Premkumar
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Abstract

The incidence of nonalcoholic fatty liver disease (NAFLD) has seen a steep rise in parallel with the global obesity and metabolic syndrome epidemic. The presence of NAFLD contributes to significant socioeconomic burden due to healthcare costs, progression of liver disease as non-alcoholic steatohepatitis (NASH), and later cirrhosis and hepatocellular carcinoma (HCC). With the advent of widely available imaging, it is also being detected as an incidental diagnosis in individuals with systemic disease like metabolic syndrome, diabetes, chronic cardiac disease, polycystic ovarian syndrome, etc. or in asymptomatic persons on presurgical evaluation or even annual health assessments. Gastroenterologists, hepatologists, physicians and surgeons need to be updated about the new diagnostic criteria of Metabolic (dysfunction)-associated fatty liver disease, noninvasive tests (NITs) of liver fibrosis, new tools of elastography, and identification of those with high-risk disease. In this review, we appraise the relevance of new diagnostic definitions, steatosis and fibrosis estimation tests, advanced imaging like magnetic resonance elastography and proton density fat fraction and discuss the diagnostic algorithm for incidentally detected NAFLD.

How to cite this article: Mishra S, Bhujade H, Butt AS, et al. Work-up for Incidentally Detected NAFLD: How Far is It Worth? Euroasian J Hepato-Gastroenterol 2022;12(Suppl 1):S26-S36.

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偶然发现的NAFLD的检查:有多值得?
非酒精性脂肪性肝病(NAFLD)的发病率随着全球肥胖和代谢综合征的流行而急剧上升。NAFLD的存在由于医疗费用、肝病进展为非酒精性脂肪性肝炎(NASH)以及后来的肝硬化和肝细胞癌(HCC)而增加了显著的社会经济负担。随着影像技术的广泛应用,在代谢综合征、糖尿病、慢性心脏病、多囊卵巢综合征等全身性疾病患者或无症状患者的术前评估甚至年度健康评估中,它也被发现是一种偶然诊断。胃肠病学家、肝病学家、内科医生和外科医生需要更新代谢(功能障碍)相关脂肪性肝病的新诊断标准、肝纤维化的无创检查(NITs)、弹性成像的新工具以及高风险疾病的识别。在这篇综述中,我们评估了新的诊断定义、脂肪变性和纤维化评估测试、磁共振弹性成像和质子密度脂肪分数等先进成像的相关性,并讨论了偶然检测到的NAFLD的诊断算法。如何引用本文:Mishra S, Bhujade H, Butt AS,等。偶然发现的NAFLD的检查:有多值得?中华肝病与胃肠病杂志,2022;12(增刊1):S26-S36。
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