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Hepatocellular adenoma (HCA) is a benign liver tumor with a low incidence. It mostly occurs in women of childbearing age, and often manifests as a single mass. This paper reported a case of multiple HCA in a middle-aged man. Serological examination showed elevated triglycerides level, and normal hepatic function. The patient had no history of viral hepatitis. Upper abdominal enhanced MRI examination showed multiple space-occupying lesions in liver, which tended to be benign. A total of 3 intrahepatic tumors were resected, and all of them were confirmed to be HCA by pathological examination. Both oncocytes and normal hepatocytes were found mild steatosis. The patient recovered well without tumor recurrence after surgery. [ABSTRACT FROM AUTHOR]

The incidence of non-alcoholic fatty liver disease(NAFLD)keeps on rise.Without intervention,it may develop to steatohepatitis,cirrhosis,and even hepatocellular carcinoma.Liver biopsy,the gold standard for evaluating the steatosis severity of NAFLD,is invasive and unsuitable for large-scale screening.In recent years,magnetic resonance imaging(MRI)-related examinations have been used as a gold standard only second to liver biopsy,which still have disadvantages in large-scale application.Ultrasound has the advantages of simple operation,low cost,and safety,and may become an important method for accessing NALFD.This review summarizes the current studies about the diagnosis of liver steatosis by quantitative ultrasound assessment,including controlled attenuation parameters,attenuation imaging,ultrasonic liver/kidney intensity ratio and liver attenuation rate,and integrated backscatter.

Objective: To evaluate the clinical value of ultrasound attenuation parameters (UAP) in diagnosing the liver steatosis degree in patients with chronic liver disease, and to explore the relevant factors that affect UAP detection values. Methods: 130 cases with chronic liver disease diagnosed as liver steatosis by liver biopsy during January 2014 to May 2019 were selected from the Hepatology Department of Integrated Traditional Chinese and Western Medicine of the Third Hospital of Hebei Medical University. UAP and liver stiffness (LSM) were detected by iLivTouch, and the body mass index (BMI) was calculated. Simultaneously, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), total bilirubin (TBil), triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL) levels and peripheral platelet (PLT) counts were measured. The correlation between UAP and liver steatosis was analyzed based on the liver histopathological results. SPSS 21.0 statistical software was used for statistical analysis. Receiver operating characteristic curve (ROC) was used to analyze the accuracy and specificity of UAP in the diagnosis of liver steatosis in patients with chronic liver disease. Spearman's rank correlation analysis was used to study the relevant factors affecting UAP value. Results: The histopathological changes of liver biopsy showed that there were 43 cases of grade F1, 47 cases of F2, 32 cases of F3 and 8 cases of F4. UAP and BMI ( r = 0.363, P < 0.001), and UAP and liver steatosis degree ( r = 0.380, P < 0.001) were positively correlated. BMI and the liver steatosis degree were independent predictors of UAP value. The cut-off points for UAP to diagnose liver steatosis degree were 276 dB/m for F≥2, 288 dB/m for F≥2, 293 dB/m for F≥3, and F = 4, respectively. The sensitivity and specificity was 0.379, 0.500, 0.750, and 0.930, 0.922, 0.836, respectively. Conclusion: Ultrasonic attenuation parameters cannot only determine the presence or absence of liver steatosis in patients with chronic liver disease, but also can better assess the liver steatosis degree.

Objectives: To determine serum Wnt5a and its associations with liver steatosis and fibrosis in overweight and obese people., Methods: The study participants were recruited from those who visited our hospital for health examinations. They were divided into three groups according to body mass index (BMI), controlled attenuation parameter (CAP)values and elasticity (E) values of liver fibroscan: Control ( n =27), Mild NAFLD (non-alcoholic fatty liver disease, n =51) and Moderate/severe NAFLD ( n =56). The waist circumference (WC), hip circumference (HC), oral glucose tolerance test (OGTT), insulin releasing test (IRT), liver function, blood lipid, serum Wnt5a and β-catenin of those participants were measured., Results: The three groups of participants had no significant differences in age, gender, BMI, WC or HC ( P >0.05). Significant differences appeared in fasting glucose, 2 h postprandial glucose and fasting insulin level between the three groups ( P <0.05), but not in 2 h postprandial insulin level ( P >0.05).The participants with NAFLD had higher levels of serum Wnt5a and β-catenin than controls ( P <0.05). Wnt5a level was correlated with CAP value ( r =-0.19, P <0.000 1), but barely with E value ( r =0.02, P =0.241)., Conclusions: Wnt5a may play a role at different stages of NAFLD in overweight/obese people.