Diagnosis of liver fibrosis in patients with nonalcoholic fatty liver disease

This article is expertly consulted by Gastroenterologist - Department of Medical Examination & Internal Medicine - Vinmec Hai Phong International General Hospital.

Nonalcoholic fatty liver disease is a liver disease caused by the accumulation of a large amount of fat, occurring in people who drink little or no alcohol. Although the disease is not dangerous, if left for a long time, it will appear many dangerous complications such as cirrhosis, liver cancer.
For patients with non-alcoholic fatty liver disease, it is necessary to evaluate the fatty liver status, assess the degree of hepatitis and liver fibrosis caused by the above condition. So what fatty liver tests should be done to assess these conditions?

Fatty liver status should be confirmed by abdominal ultrasound. Ultrasound is a laboratory test available in most medical facilities. In addition, through ultrasound can detect more information about the liver and biliary tract. Therefore, liver ultrasonography is an imaging diagnosis that must be performed in patients with non-alcoholic fatty liver disease.
Controlled Attenuation Parameter (CAP) is another imaging technique used to diagnose fatty liver. This method allows to determine the degree of fatty liver.
There are also other indicators used to assess good fatty liver status such as:
Fatty liver index (FLI) Steato Test NAFLD liver fat score

Patients with nonalcoholic steatohepatitis are at increased risk of developing cirrhosis, cirrhosis, and possibly even liver cancer. Therefore, they need to be closely monitored and treated more aggressively than other patients.
However, clinical signs, biochemical tests as well as imaging studies cannot distinguish nonalcoholic steatohepatitis from fatty liver alone. For a definitive diagnosis of this condition, a liver biopsy is required.

The degree of liver fibrosis is one of the important prognostic factors for patients with nonalcoholic fatty liver disease. This condition is correlated with the outcome and mortality of patients with liver disease. Therefore, it is necessary to closely monitor the progression of liver fibrosis in patients with nonalcoholic fatty liver disease.
There are many scales used to evaluate the degree of liver fibrosis such as: NFS: NAFLD fibrosis score, FIP-4 (Fibrosis 4), ELF (Enhanced Liver Fibrosis) and FibroTest. The NFS index can distinguish the presence or absence of severe cirrhosis.
Liver elastography is a noninvasive technique used to evaluate liver fibrosis. This technique helps to identify low-risk cases of severe cirrhosis and cirrhosis.
The combination of biomarkers along with indicators of liver fibrosis and liver elastography helps to increase the accuracy of disease diagnosis. At the same time avoid doing liver biopsy. It is also used clinically to monitor the progression of liver fibrosis in nonalcoholic fatty liver disease.
Thus, to diagnose liver fibrosis in patients with nonalcoholic fatty liver disease, it is necessary to do a number of paraclinical tests such as blood tests, imaging tests, liver biopsies. In particular, the technique of elastography of liver tissue is a modern technique that is widely applied today thanks to its non-invasive advantages, allowing accurate assessment of cirrhosis.