| Abstract [eng] |
Aim. The purpose was to evaluate the accuracy of ultrasound and magnetic resonance imaging of diffuse liver diseases – liver fibrosis and steatosis. Methods. MEDLINE database was searched to identify studies published from 2017 to 2022 conducted on adults investigating the diagnostic accuracy of transient elastography (TE), 2D shear wave elastography (2D–SWE), point shear wave elastography (pSWE) or magnetic resonance elastography (MRE) for detecting liver fibrosis as well as attenuation imaging (ATI), ultrasound guided attenuation parameter (UGAP) or controlled attenuation parameter (CAP) for detecting liver steatosis. Results. A total of 26 studies were included: 16 studies analyzing diagnostic accuracy of TE, 2D–SWE, pSWE and MRE in evaluating liver fibrosis, as well as 10 studies analyzing ATI, CAP and UGAP accuracy in evaluating liver steatosis. When diagnosing liver fibrosis, MRE AUROC exceeded 0,8, sensitivity and specificity were respectively 0,75–1,0 and 0,43–1,0; AUROC, sensitivity and specificity of TE were respectively 0,67–0,97, 0,54–0,96 and 0,39–0,97; AUROC, sensitivity and specificity of 2D–SWE were respectively 0,65–0,97, 0,58–1,0 and 0,12–1,0; AUROC, sensitivity and specificity of pSWE were respectively 0,70–0,96, 0,58–0,92 and 0,25–0,93. When evaluating liver steatosis, AUROC of both ultrasound methods exceeded 0,8. Sensitivity and specificity of ATI (UGAP) were respectively 0,65–1,0 and 0,71–0,96. Sensitivity and specificity of CAP were respectively 0,71–0,91 and 0,47–1,0 Conclusions. MRE is the most precise method when evaluating liver fibrosis at any stage of fibrosis. Ultrasound based methods are less precise, the performance varies from suboptimal to great. Ultrasound methods are most precise when diagnosing advanced fibrosis and cirrhosis. There were no significant differences in diagnostic accuracy between TE, 2D–SWE and pSWE. When evaluating liver steatosis, ultrasound elastography methods are very precise. ATI and UGAP are slightly more precise methods than CAP when diagnosing liver steatosis. |
