Comparison of transient elastography to Doppler indices in prediction of hepatitis C induced liver fibrosis and cirrhosis

Abstract

ObjectivesThe aim of our study was to examine the efficiency of transient elastography (TE) and Doppler indices, namely hepatic vein damping index (DI) and splenic artery pulsatility index (SAPI) for evaluating the degree of hepatic fibrosis in chronic hepatitis C (CHC) patients. Patients and methodsOne hundred and ten CHC patients were enrolled. Hepatic vein DI, SAPI, and TE were performed to all patients before liver biopsy. Fibrosis was assessed on semi quantitative scoring system (METAVIR score). We examine the efficiency of each test in differentiating different stages of hepatic fibrosis and their diagnostic accuracy in predicting significant fibrosis F⩾2 and cirrhosis. ResultsTE showed the best results in differentiating different stages of fibrosis (p<0.001), TE had the best diagnostic accuracy for prediction of significant fibrosis and cirrhosis (AUROCs: for F⩾2 TE 0.92 vs. SAPI 0.74, DI 0.75; for cirrhosis TE 0.95 vs. DI 0.80, SAPI 0. 79). At a cut-off of 7kPa, TE predicted significant fibrosis with 87% sensitivity and 86% specificity, it correctly classified 87% of patients vs. 71% for DI and 68% for SAPI. For prediction of cirrhosis, TE at 16.5kPa had 87% sensitivity and 91% specificity it correctly classified 90% of patients vs. 70% for DI and 68% for SAPI. ConclusionTE is a non-invasive technique to accurately detect the presence of significant fibrosis and cirrhosis in patients with CHC. While the ability of Doppler tests was limited.