الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
For defining non-alcoholic fatty liver disease ”NAFLD” there must be evidence of hepatic steatosis and lack of secondary causes of hepatic fat accumulation in the absence of excessive alcohol intake.
NAFLD and non-alcoholic steatohepatitis (NASH) are increasing worldwide. NASH is characterized by an active liver inflammation associated with severe consequences including progressive cirrhosis, and even hepatocellular carcinoma.
The only reliable method of differentiating simple steatosis from NASH is Liver biopsy. NAFLD is found to be an additional feature of metabolic syndrome. The ‘multiple-hits hypothesis’ is a possible explanation for the pathogenesis of NAFLD.
NASH and fibrosis is suggested by Non-invasive tests such as liver enzymes, medical imaging, Fatty Liver Index, NAFLD fibrosis score, FibroMeter and Fibroscan. This is also confirmed by liver biopsy.
The overall global prevalence of NAFLD diagnosed by imaging is around 25.24% the highest prevalence of NAFLD is reported from the Middle East and South America 30.45% and the lowest prevalence rate is reported from Africa 13.48%.
Liver biopsy has been the gold standard for diagnosis and staging of liver fibrosis but many recent studies clearly highlight several drawbacks of liver biopsy, including variable accessibility, high cost, sampling errors, and inaccuracy due to inter- and intra-observer variability of pathologic interpretations.
Ultrasound is a safe, radiation-free, easily available, cost-effective way of determining fatty infiltration of liver. Real time elastography has been reported to be useful for the prediction of fibrosis in patients with non-alcoholic fatty liver disease with accuracy reaching 92%. It has been found to have a good correlation with liver fibrosis stage determined by histopathologic examination of biopsy samples.
The aim of this study was to assess the applicability and performance of real-time elastography for diagnosis of liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) compared with NAFLD-fibrosis score and FIB-4 Index.
Our results found good correlation between finding of the real time elastography and NAFLD score in advanced stages with good correlation between finding of the real time elastography and FIB-4 score in advanced stages of liver diseases.
Also, our study found that in advanced NAFLD score there is a good correlation between Grade of fatty liver and NAFLD score.