소아 비알코올성 지방간질환의 병리 소견과 임상적, 영상학적 소견의 상관성

Abstract

Background/Aims: Nonalcoholic steatohepatitis (NASH) is the progressive form of non-alcoholic fatty liver disease (NAFLD), and its prevalence is increasing worldwide. Liver biopsy remains the best way to diagnose NASH and establish the presence of fibrosis, but has not been performed easily in children because of its invasiveness. We analyzed the ultrasonographic and histopathologic findings of pediatric NAFLD patients, and studied to find their association with clinical haracteristics and laboratory findings. Methods: The study involved 18 obese children ranging from 7 to 15 years of age, who were diagnosed with NASH by liver biopsy. We performed the abdomen ultrasonography before the liver biopsy. We reviewed their pathology slides and classified them by NASH CRN (Clinical Research Network) scoring system. We also reviewed the abdomen ultrasonographic findings of the patients and classified them into grade of 1, 2, and 3. We reviewed the medical records of the patients and investigated their clinical characteristics and laboratory findings. Results: The ultrasonographic grades had significant association with NAFLD activity score, grade of steatosis amount, ballooning change, and portal nflammation. Serum triglyceride level was significantly higher in patients who showed high grade steatosis and high NAFLD activity score. Conclusions: This study showed that serum triglycerides and ultrasonographic findings are highly correlated with pathologic findings in children with NAFLD. (Korean J Gastroenterol 2011;57:158-165)