22. Factors influencing detection of liver stiffness by transient elastography

Abstract

Background and Aims: Transient elastography (TEE) is a useful, noninvasive, quantitative method for evaluating liver fibrosis by measuring the liver stiffness (LSM). This study investigated factors affecting detection of liver fibrosis by TEE, in cases where there is a discordance of more than one fibrosis stage between TEE and liver biopsy. Methods: Cross sectional study of patients undergoing liver biopsy because of high TEE with persistent transaminitis/normal TEE with persistent transaminitis/high TEE with normal transaminases. Gender, Age, BMI, CBC, RFT, LFT, Etiology, TEE fibrosis score (within 3 months of liver biopsy), Liver biopsy fibrosis score (Metavir). TEE fibrosis score of study population was compared to liver biopsy fibrosis scores, which is considered as gold standard, and patients with discordance of more than one fibrosis stage was analyzed with above mentioned variables which can affect TEE. Results: 54 patients, 35 male and 19 female were included in the study. Mean age of population was 42.2 years. 32 (59%) had NASH, 14 (25.9%) had Chronic hepatitis B, 6 (11.1%) had Chronic hepatitis C and 2 (3.7%) had Autoimmune hepatitis. After applying Spearman's correlation, INR had moderate strength of positive correlation (rs) value of 0.421 and P value of 0.029. A weak positive correlation was found between Age (0.208), Total bilirubin (0.397), Direct bilirubin (0.286), ALP (0.302), RBS (0.247), HDL (0.279) and LSM. A weak negative correlation was found between Albumin (−0.313), Urea (−0.208), Creatinine (−0.325), Ceruloplasmin (−0.221) and LSM. Conclusions: Age, Bilirubin, ALP, Albumin, RFT, RBS, HDL, Ceruloplasmin, INR, affects the LSM detection by TEE and should be taken into account while interpreting TEE scores. There was no correlation of transaminases with TEE score. The authors have none to declare.