Correlation between liver stiffness measured by shear-wave elasticity imaging and pathological grades and stages of chronic hepatitis B

Abstract

Objective To investigate the correlation between Young's elastic modulus (EI) using shear wave elastography (SWE) and liver pathology. Methods Liver biopsy was performed on 231 patients with chronic hepatitis B (CHB) under supersonic guidance, and SWE with EI of liver was obtained concurrently. The correlation between measured liver stiffness and pathology was analyzed by using the liver pathology as golden standards. One-way analysis of variance and Spearman rank correlation analysis were performed for the comparison between groups and correlation between two variables, respectively. Receiver operating characteristic (ROC) curve was used to explore the predictive value of shear modulus for the liver inflammation grades and fibrosis stages. Results The EI medians of different liver inflammation grades were 6.78 kPa (G1), 7.30 kPa (G2), 9.93 kPa (G3) and 14.93 kPa (G4), respectively, which were statistically different (H=55.19, P<0.01). And EI medians of various fibrosis stages were 6.62 kPa (S0-S1), 7.15 kPa (S2), 9.78 kPa (S3) and 14.62 kPa (S4), respectively, which were also significantly different (H=62.14, P<0.01). EI was positively correlated with both liver inflammation grades (r=0.454 6, P<0.01) and liver fibrosis stages (r=0.505 6, P<0.01). The areas under the ROC for G≥2, G≥3 and G=4 were 0.68 (95%CI: 0.61-0.75), 0.77 (95%CI: 0.70-0.84) and 0.85 (95%CI: 0.77-0.92), respectively. The areas under the ROC for S≥2, S≥3 and S=4 were 0.73(95%CI: 0.66-0.79), 0.78(95%CI: 0.72-0.85) and 0.83(95%CI: 0.75-0.91), respectively. Conclusion The EI measured by SWE is correlated with liver pathology of CHB patients, which may be used to dynamically monitor the progress of liver fibrosis. Key words: Hepatitis B, chronic; Ultrasonography; Shear-wave elasticity imaging techniques; Elastic modulus