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Review

Diagnosis and Staging of Pediatric Non-Alcoholic Fatty Liver Disease: Is Classical Ultrasound the Answer?

1
Laboratory of Histology and Embryology, School of Medicine, Faculty of Health, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
2
2nd Department of Ophthalmology, School of Medicine, Faculty of Health, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
3
Department of Biomedical Sciences, School of Health Sciences, International University of Greece, 574 00 Thessaloniki, Greece
*
Author to whom correspondence should be addressed.
Academic Editor: Maurizio Aricò
Received: 9 March 2021 / Revised: 19 May 2021 / Accepted: 1 June 2021 / Published: 8 June 2021
The increased prevalence of non-alcoholic fatty liver disease (NAFLD) requires special attention in pediatric patients, as it manifests in them in a more severe and progressive way compared to adults. The implementation of the appropriate therapeutic interventions is determinant of the attempts to treat it. For that purpose, early diagnosis and staging of the disease is essential. The purpose of this review was to find and reveal the most appropriate diagnostic strategies and tools for diagnosis and staging of pediatric NAFLD/NASH based on their accuracy, safety and effectiveness. The methodology followed was that of the literature review. Particular emphasis was put on the recent bibliography. A comparative study of published articles about the diagnosis and management of pediatric NAFLD/NASH was also performed. In terms of diagnosis, the findings converged on the use of classical ultrasound. Ultrasound presented average sensitivity and specificity for diagnosing the disease in children, while in the adult population, sensitivity and specificity were significantly higher. Proton density fat fraction magnetic resonance imaging has been increasingly used for the diagnosis of steatosis in pediatric patients. Elastography is an effective tool for staging liver fibrosis and discriminating NASH from NAFLD in children. Even though liver biopsy is the gold standard, especially for NASH, it should be avoided for pediatric patients. Biochemical tests are less specific and less sensitive for the diagnosis of NAFLD, and some of them are of high cost. It seems that diagnostic imaging should be a first-line tool for the staging and monitoring pediatric NAFLD/NASH in order for appropriate interventions to be implanted in a timely way. View Full-Text
Keywords: NAFLD; pediatric NAFLD/NASH; diagnosis; ultrasound; children; elastography; staging NAFLD; pediatric NAFLD/NASH; diagnosis; ultrasound; children; elastography; staging
MDPI and ACS Style

Papachristodoulou, A.; Kavvadas, D.; Karamitsos, A.; Papamitsou, T.; Chatzidimitriou, M.; Sioga, A. Diagnosis and Staging of Pediatric Non-Alcoholic Fatty Liver Disease: Is Classical Ultrasound the Answer? Pediatr. Rep. 2021, 13, 312-321. https://0-doi-org.brum.beds.ac.uk/10.3390/pediatric13020039

AMA Style

Papachristodoulou A, Kavvadas D, Karamitsos A, Papamitsou T, Chatzidimitriou M, Sioga A. Diagnosis and Staging of Pediatric Non-Alcoholic Fatty Liver Disease: Is Classical Ultrasound the Answer? Pediatric Reports. 2021; 13(2):312-321. https://0-doi-org.brum.beds.ac.uk/10.3390/pediatric13020039

Chicago/Turabian Style

Papachristodoulou, Angeliki, Dimitrios Kavvadas, Athanasios Karamitsos, Theodora Papamitsou, Maria Chatzidimitriou, and Antonia Sioga. 2021. "Diagnosis and Staging of Pediatric Non-Alcoholic Fatty Liver Disease: Is Classical Ultrasound the Answer?" Pediatric Reports 13, no. 2: 312-321. https://0-doi-org.brum.beds.ac.uk/10.3390/pediatric13020039

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