Hepatic Artery Resistive Index (HARi) and bard fibrosis score: Risk assessment of advanced liver fibrosis in patients with Non-Alcoholic Fatty Liver Disease (NAFLD).
- Author:
Ernie G. Bautista
1
Author Information
- Publication Type:Journal Article
- Keywords: Non-alcoholic fatty liver disease; hepatic artery resistive index; BARD Fibrosis score; liver fibrosis; ultrasonographic grading
- From: Journal of the Philippine Medical Association 2021;100(1):14-28
- CountryPhilippines
- Language:English
-
Abstract:
INTRODUCTION:Nonalcoholic fatty liver disease
(NAFLD) is a metabolic disorder with a wide clinical
continuum of liver diseases like focal hepatic
steatosis, steatohepatitis, advanced fibrosis, and
cirrhosis that usually progress in a rectilinear
fa sh ion. Through this course, NAFLD endure
certain hemodynamic changes in the hepatic
arterial blood flow. Thus, identification of patients
with advanced liver fibrosis is indispensable.
PURPOSE:To determine the concordance of Hepatic Artery Resistive Index (HARi) and Bard Fibrosis Score in the assessment of advanced liver fibrosis among patients with NAFLD and across its different disease severity.
MATERIALS AND METHODS:Observational descriptive study design was used. 94 NAFLD patients without history of excessive alcohol consumption were invited and voluntarily participated in the research investigation. Ultrasound scanning of the liver to include color Doppler parameters (Peak systolic volume [PSV], end diastolic volume [EDV] and HAR/) and determination of BARD Fibrosis score (Body mass index [BM/], fasting blood sugar [FBS] and AST/ ALT ratio) were done. Different grading across NAFLD was established.
RESULTS:The HARi of NAFLD with BARD Fibrosis scores of 1, 2, 3, and 4 has an average index of 0.84, 0.75 0.54 and 0.52, respectively. There is an unwavering inverse correlation between HARi to BARD Fibrosis scoring system (r=-0.84). Across the different severity of NAFLD, grade Ill (severe) has the lowest mean HARi at 0.53 followed by grade 11 (moderate) at 0.76 and grade I (mild) at 0.81. Correspondingly, the BARD Fibrosis score showed inverse ranking pattern across the different severity of NAFLD. Grade I (mild) has the lowest BARD fibrosis score followed by grade II (moderate) and grade Ill (severe), which yielded having a mean score of 1.00, 3.29 and 3.56, respectively.
CONCLUSION:The HARi has demonstrated a significant negative correlation with advanced liver fibrosis when correlated with BARD fibrosis score. Thus, this study showed that the conventional Doppler US with hepatic artery indices and laboratory variables are helpful in detecting fibrous tissue accumulation in the course of NAFLD. - Full text:hepatic.pdf
