Nonalcoholic steatohepatitis (NASH) is manifestation of metabolic syndrome in the liver and is a pandemic over the globe especially in the developed countries, based on a high calorie diet and sedentary life style. As in the other types of chronic hepatitis, collagen fibers continuously accumulate in the liver through the course of NASH toward cirrhosis and hepatocellular carcinoma development. Histological evaluation is a current gold standard for quantification of the fiber deposition. A tiny biopsy specimen, however, leads to considerable variability and is practically difficult to obtain repeatedly from multiple sites. Several surrogate markers have been developed for evaluation of fiber accumulation in a noninvasive way. Unfortunately, however, so far no methodology can satisfy both specificity for the liver and applicability for multiple sites.
A research article to be published on June 21, 2010 in the World Journal of Gastroenterology addresses this question. A research team led by Takeshi Suda, from Department of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, investigated the efficacy of shear wave velocity (SWV) measurement in the evaluation of NASH pathophysiology using ACUSON S2000 ultrasound system.
This research revealed significant positive correlation between SWV and the histological fibrous stages and suggested the possibility to distinguish mild fibrosis from severe fibrosis or cirrhosis with substantial accuracy. Furthermore, the correlations of SWV with biochemical markers such as hyaluronic acid or albumin were presented. This is the first report suggesting that SWV can be reproducibly measured in NASH and varies through the liver.
Due to the non-invasive and easily accessible nature of SWV measurement, this technology makes it possible to conduct a longitudinal evaluation of liver rigidity at multiple sites of the liver in a large cohort. The actual longitudinal evaluation in a larger NAFLD population may prove not only useful for fibrous staging of NASH but also for the process of fiber accumulation and value as a prognostic indicator.
Reference: Osaki A, Kubota T, Suda T, Igarashi M, Nagasaki K, Tsuchiya A, Yano M, Tamura Y, Takamura M, Kawai H, Yamagiwa S, Kikuchi T, Nomoto M, Aoyagi Y. Shear wave velocity is a useful marker for managing nonalcoholic steatohepatitis. World J Gastroenterol 2010; 16(23): 2918-2925
Correspondence to: Takeshi Suda, MD, PhD, Associate Professor, Department of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata 951-8122, Japan. email@example.com
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World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2009 IF: 2.092. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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