Part 3: Interpretation of Ultrasound, FIbroscan and MRI modalities for MASLD скачать в хорошем качестве

Part 3: Interpretation of Ultrasound, FIbroscan and MRI modalities for MASLD

Part 3 of the LIPAGLYN MASLD PRO 2025 These are the topics discussed 1. Role of USG in screening and diagnosis of MASLD 2. Understanding VCTE (Transient elastography / Fibroscan) in MASLD 3. Role of MRI in MASLD If not done already, please also sign up on our Technocrinology.com platform to get access to all the previous lectures, notes on the current lectures, and tools and applications : https://technocrinology.thinkific.com... Role of Ultrasound in MSLD Management [00:06:14-00:15:04] Basic Appearance of Fatty Liver [00:07:53] Appears hyperechoic compared to kidney Requires at least 20% fat content to be detected Lower sensitivity (60-65%) for mild fat content Grading System [00:11:42] Grade 1: Slight increase in echogenicity, visible portal veins & diaphragm (20-30% fat) Grade 2: Blurred portal veins, visible diaphragm (30-60% fat) Grade 3: No visible portal veins or diaphragm (More than 60% fat) Clinical Applications [00:15:52] Screening: Limited by low sensitivity Serial monitoring: Available but not ideal Limitations: Obesity, operator dependence Role of Fibroscan/Transient Elastography [00:23:16-00:42:01] Basic Principles [00:23:39] Uses shear waves to measure liver stiffness Measures both stiffness (fibrosis) and fat content Requires 8-hour fasting Technical Considerations [00:27:11] Probe selection (M vs XL for obese patients) Need for More than 10 valid measurements IQR/Median ratio Less than 30% Proper probe placement important Interpretation [00:33:06] CAP (Controlled Attenuation Parameter) for fat measurement Less than 238: No steatosis 238-260: S1 (mild) 260-290: S2 (moderate) More than 290: S3 (severe) LSM (Liver Stiffness Measurement) for fibrosis Less than 5.5 kPa: Normal 5.5-8 kPa: Mild fibrosis 8-10 kPa: F2 fibrosis 10-14 kPa: F3 fibrosis More than 15 kPa: F4 (cirrhosis) Role of MRI in MSLD [00:42:19-00:53:50] Three Key Modalities [00:42:25] 1. MRI-PDFF (Proton Density Fat Fraction) Detects as low as 5% fat Better sensitivity than ultrasound Used in clinical trials 2. MR Elastography [00:44:42] Measures liver stiffness Higher accuracy than Fibroscan Better for obese patients 3. cT1 Mapping [00:47:18] Detects inflammation and steatohepatitis Used alongside PDFF in trials Useful for monitoring treatment response Clinical Applications [00:51:29] Diagnostic algorithm starting with PDFF Serial monitoring possible Available in India on 1.5T/3T machines Growing use in clinical trials