Ultrasound imaging in nonalcoholic liver disease: current applications and future developments

In 1980, Ludwig described non-alcoholic liver disease (NAFLD) in patients who did not drink alcohol, but whose liver histology showed alcoholic-like liver disease (1). NAFLD includes a range of diseases from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH). The prevalence of NAFLD is highest in the Middle East (31.8%), followed by Asia (27.4%), USA (24.1%) and Europe (23.7%), to the lowest (13.5%) in Africa (2). Accordingly, NAFLD has emerged as the most common chronic liver disease worldwide. The overall global economic burden increases as the clinical consequences of NAFLD grow, including liver-specific, cardiovascular disease and overall mortality (3). Compared to the effective anti-viral treatments for viral chronic hepatitis, the management of NAFLDs is still under development. Although there is no universal consensus, many scientific communities have developed guidelines for diagnosis and treatment.