Abstract
Objective To investigate the clinical value of the acoustic radiation force impulse imaging (ARFI) in the quantitative evaluation of fibrosis staging in chronic hepatitis B. Methods A total of 373 patients with chronic hepatitis B were grouped in accordance with the depth of the right anterior lobe and posterior lobe of the liver and underwent ARFI to measure ARFI values. Liver biopsy was performed in all patients to investigate the relationship between liver fibrosis stages and ARFI values in different groups. Results The ARFI values in different pathological grades with the same depth of the right anterior and right posterior lobe of the liver were statistically significant (P<0.001); the ARFI values between the middle and deep parts of the right anterior lobe and the same location of the right posterior lobe were statistically significant (P<0.01); for the right anterior lobe, the ARFI value of the shallow part showed statistical significance from that of the middle and the deep part (P<0.05). Receiver operating characteristic (ROC) curve analysis for different sampling locations showed that the largest area under the ROC curve, which was 0.818, existed in the middle part of the right anterior lobe, indicating that it could be the optimal sampling location for the measurement of ARFI values. Liver stiffness at ARFI imaging was significantly correlated with liver fibrosis stage in chronic hepatitis B and spearman coefficient of correlation was 0.530 (P<0.001). The areas under the ROC curves for the chronic hepatitis B patients with severe liver fibrosis (≥S3) and early cirrhosis (=S4) were 0.818 and 0.860, respectively. Conclusions ARFI imaging was promising for clinical application and could be utilized as a noninvasive method for the quantitative evaluation of fibrosis staging in chronic hepatitis B. Key words: Ultrasonography; Hepatitis B, chronic; Liver cirrhosis; Acoustic radiation force impulse
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