Diagnostic Approach

  • Marko Duvnjak
  • Nina Blažević
Part of the Clinical Gastroenterology book series (CG)


Non-alcoholic fatty liver disease (NAFLD) with its two clinically different entities [non-alcoholic fatty liver disease (NAFL) and non-alcoholic steatohepatitis (NASH)] is a condition affecting an increasing number of people worldwide, predominantly diagnosed with non-invasive imaging techniques. Serological testing can be subdivided into three groups based on the stage of NAFLD and includes several tests: SteatoTest, NAFLD fibrosis score and ultrasonographic fatty liver indicator. Cytokeratin-18 is the single serologic test most studied so far regarding the diagnosis of NASH. Non-invasive imaging techniques include ultrasonography as the first frontier in the diagnostic algorithm, transient elastography (FibroScan) and acoustic radiation force impulse (ARFI) elastography as important tools used to determine the extent of the liver stiffness, and computed tomography (CT)/magnetic resonance imaging (MRI). However, liver biopsy still remains the gold standard for the diagnosis and classification standards of NAFLD, though this procedure should only be used when there is lack of more beneficial alternatives, due to its invasiveness and potential risks. It is important to say that patients have to be evaluated periodically and efficiently assessed in order to determine treatment results and lifestyle changes that have to be made to manage hepatic steatosis and other further complications.


Non-alcoholic fatty liver Steatohepatitis Serological testing Non-invasive imaging techniques Liver biopsy 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Marko Duvnjak
    • 1
    • 2
  • Nina Blažević
    • 1
  1. 1.Department of Gastroenterology and HepatologySestre milosrdnice University Hospital CenterZagrebCroatia
  2. 2.University of Zagreb School of MedicineZagrebCroatia

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