Modern ultrasonic methods of diagnostics of hepatic steatosis

The prevalence of non-alcoholic fatty liver disease, according to various estimates, affects a quarter of the world population. Significant interest in this pathology is due to the high frequency of adverse liver (steatohepatitis, liver fibrosis and cirrhosis) and extrahepatic (association with cardiovascular disease) outcomes. One of the key areas is the timely diagnosis of liver steatosis. Reference diagnostic methods, which include liver biopsy and magnetic resonance imaging with assessment of liver fat proportion weighted by proton density, have objective practical and financial limitations for their routine use in detection and quantitative assessment of liver steatosis. Therefore, one of the current trends in hepatology is the development of inexpensive, widely applicable, and reliable noninvasive diagnostic tools. The aim of the present review is a comparative analysis of various ultrasound methods of liver steatosis diagnostics: qualitative, semi-quantitative and quantitative (estimation of hepatorenal index, controlled attenuation parameter). The presented publication reviews the currently available methods of detection and assessment of severity of liver steatosis based on ultrasound examination, including their classification, methodology and comparison of diagnostic efficiency with analysis of intra- and inter-operator reproducibility, sensitivity and specificity.