Diagnostic usefulness of real-time elastography for liver fibrosis in chronic viral hepatitis B and C.

Young Woon Kim,Min Ju Kim,Soon Woo Nam,Eun Su Park,Byong Sun Oh,Jung Hyun Kwon,Kyu Won Chung,Jeong Won Jang

doi:10.1155/2014/210407

Abstract

The aim of this study was to investigate the diagnostic usefulness of real-time elastography (RTE) for liver fibrosis in chronic viral hepatitis B (CHB) and C (CHC). Fifty-one and thirty-two of the patients were diagnosed with CHB and CHC, respectively. Enrolled patients underwent liver biopsy and RTE. The FIB-4 index and aspartate transaminase-to-platelet ratio index (APRI) were also measured. The liver fibrosis index (LFI) by RTE increased significantly with the Knodell fibrosis stage: 3.14 ± 0.62 for F0, 3.28 ± 0.42 for F1, 3.43 ± 0.53 for F3, and 4.09 ± 1.03 for F4 (P = 0.000). LFI as well as APRI, FIB-4, platelet, albumin, and prothrombin time showed the difference in patients with advanced fibrosis (≥F3) and those with mild fibrosis (≤F1). In addition, RTE had better discrimination power between ≥F3 and F4 than between FIB-4 and APRI. In CHC patients, the area under receiver operating characteristic curves of RTE for advanced fibrosis was higher than that in CHB patients (0.795 versus 0.641). RTE is useful for the assessment of advanced fibrosis in patients with CHB and CHC and has better discrimination power than other serologic markers.

Highlights

IntroductionIn patients with a chronic liver disease, precise understanding of the hepatic fibrosis stage is important to estimate the prognosis
Chronic liver diseases are a major cause of morbidity and mortality worldwide
In patients with a chronic liver disease, precise understanding of the hepatic fibrosis stage is important to estimate the prognosis. This is especially important in deciding an antiviral therapy for patients with chronic hepatitis B virus (HBV) infection, because those with advanced fibrosis need prompt treatment [1]

Summary

Introduction

In patients with a chronic liver disease, precise understanding of the hepatic fibrosis stage is important to estimate the prognosis. This is especially important in deciding an antiviral therapy for patients with chronic hepatitis B virus (HBV) infection, because those with advanced fibrosis need prompt treatment [1]. Liver biopsy is still the gold standard for the assessment of liver fibrosis [2]. It is an invasive procedure that has many procedure-related risks and is difficult to perform repeatedly to check progression of the fibrosis. There has been increasing interest in noninvasive assessment of hepatic fibrosis in clinical practice using serum markers and scoring systems or noninvasive instruments and devices

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