Ibroscan and Ultrasonography in the Evaluation of Hepatic Steatosis and Fibrosis Amongst Candidates for Bariatric Surgery

Abstract

Background: The prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing worldwide. NAFLD is closely associated with obesity and is more common in candidates for bariatric surgery. This study compared the results of ultrasonography, transient elastography (FibroScan), and liver biopsy in assessing hepatic steatosis and fibrosis severity. Methods: This cross-sectional study was conducted at Al-Zahra Hospital, Isfahan, Iran, from 2018 to 2020. Participants in the study were candidates for bariatric surgery with a body mass index (BMI) of more than 40. All patients underwent preoperative liver assessment via ultrasonography, FibroScan, and liver biopsy. The results of the different methods were compared in terms of hepatic steatosis grade and hepatic fibrosis stage. Findings: 36 patients with a BMI of more than 40 who were candidates for bariatric surgery were included in the study; 69.4 of whom (n = 25) were female. The average BMI for men was calculated as 47.21 ± 5.72 (SD) and 44.54 ± 3.03 for women. No significant difference was observed between FibroScan and liver biopsy results regarding the severity of liver fibrosis (P = 0.83). There was a significant difference between steatosis grade based on biopsy and ultrasound findings (P < 0.001). Additionally, no significant difference was observed between hepatic steatosis grade and fibrosis stage based on liver biopsy (P = 1.00). Conclusion: We have shown that the results of FibroScan are statistically similar to those of liver biopsy and this non-invasive method is a reliable alternative to biopsy among patients with morbid obesity. We also showed that the results of ultrasound in patients with a BMI greater than 40 are not accurate and reliable when compared to biopsy. Keywords: Liver cirrhosis; Obesity; Non-alcoholic fatty liver disease Citation: Sayyadi shahraki M, Mahmoudieh M, Farghadani M, Heidarpour M, Amirikashani H. Ibroscan and Ultrasonography in the Evaluation of Hepatic Steatosis and Fibrosis Amongst Candidates for Bariatric Surgery. J Isfahan Med Sch 2025; 43(826): 935-940. © 2025, Isfahan University of Medical Sciences(IUMS). All rights reserved.