Evaluation Of Hepatic Fibrosis Research Articles

Role of Ultrasound and Magnetic Resonance Elastography in Evaluation of Hepatic Fibrosis in Patients with Viral Hepatitis B And C : A Clinical Review

Role of Ultrasound and Magnetic Resonance Elastography in Evaluation of Hepatic Fibrosis in Patients with Viral Hepatitis B And C : A Clinical Review

Clinical Significance of Red Distribution Width to Platelet Ratio in Evaluation of Hepatic Fibrosis in Metabolic Dysfunction Associated Fatty Liver Disease

Clinical Significance of Red Distribution Width to Platelet Ratio in Evaluation of Hepatic Fibrosis in Metabolic Dysfunction Associated Fatty Liver Disease

Epidemiology, screening, and Co-management of type 2 diabetes mellitus and Metabolic-dysfunction associated steatotic liver disease.

Metabolic-dysfunction associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), is increasingly recognized as a prevalent global burden. Type 2 diabetes mellitus (T2DM), another important metabolic disease, is considered a major contributor to the development of MASLD. MASLD and T2DM have a strong association with each other due to shared pathogenic mechanisms. The co-existence of the two diseases increases the risk of liver-related adverse outcomes, and imposes a heavier burden on extrahepatic outcomes, representing a substantial public health issue. Effective assessment and management of T2DM combined with MASLD necessitate a multidisciplinary approach. The emergence of numerous randomized clinical trials has shed light on the treatment of T2DM combined with MASLD. This review uncovered the epidemiology of the intertwined T2DM and MASLD, offer insights into the evaluation of hepatic fibrosis in T2DM patients, glucose monitoring in MASLD population, and provide comprehensive co-management strategies for addressing both diseases.

Evaluation of Hepatic Fibrosis and Hepatic Steatosis by Pulse Elastography (FIBROSCAN/CAP) in Asymptomatic Patients about 170 Cases at the Donka CHU National Hospital in Conakry

Evaluation of Hepatic Fibrosis and Hepatic Steatosis by Pulse Elastography (FIBROSCAN/CAP) in Asymptomatic Patients about 170 Cases at the Donka CHU National Hospital in Conakry

Principles of risk stratification in nonalcoholic fatty liver disease. A narrative review emphasizing non-invasive strategies

Nonalcoholic fatty liver disease (NAFLD) is an umbrella definition that describes the ectopic deposition of fat within the liver that occurs in the absence of inciting factors other than the metabolic syndrome and its individual features. NAFLD has a multi-factorial pathogenesis which determines heterogeneous clinical phenotypes and variable natural course spanning from liver-related (steatohepatitis, fibrosis, cirrhosis, hepatocellular carcinoma) to extrahepatic outcomes (cardio-metabolic and cancer). This narrative review article leverages the key aspects of disease natural history as the background information to discuss studies that may inform strategies to risk-stratify NAFLD patients. Evaluation of hepatic fibrosis with non-invasive tools, including blood-based biomarkers and imaging-based elastometry techniques, seemingly retains the core information useful to predict the heterogeneous outcomes listed above. Additionally, genetic testing and metabolomic profiles may also be utilized to this end. In conclusion, a comprehensive understanding of the variable hepatic, cardio-metabolic and cancer outcomes of NAFLD may enable physicians and researchers to risk-stratify and accurately identify the multilayered prognosis of NAFLD individuals while also defining homogeneous patient subsets to enroll in clinical trials.

Evaluation of hepatic fibrosis by transient elastography in βthalassemia children before and after hematopoietic stem cell transplantation

Abstract Background Iron overload is a major concern in all patients with transfusion-dependent thalassemia (TDT). The liver, being a target for iron deposition is at risk of developing liver fibrosis or even cirrhosis. Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative treatment in clinical practice, a process that is surrounded by several precautions and complications that may affect the liver condition as well. Aim To evaluate the degree of hepatic fibrosis in children with TDT before and after HSCT. Methodology Twenty-five children with TDT who underwent HSCT were investigated by serum ferritin in addition to the assessment of liver fibrosis using transient elastography by FibroScan and liver fibrosis scores before and 1-year after HSCT. Results Out of the 25 children enrolled, only 16 completed a 1-year post-transplantation follow-up period. Slightly increased liver stiffness values measured by FibroScan 1-year post-transplantation, but the patients were still having the same degree of fibrosis of the pre-transplant period. FIB-4 score and APRI also showed statistically significant increase post-transplant as compared to pre-transplantation. Conclusion Stationary degree of fibrosis in thalassaemic children after HSCT with slight increases in the liver stiffness values by transient elastography that necessitates longer follow-up of the fibrosis status of patients’ post-transplant. Transient elastography is considered a helpful noninvasive tool for assessment of the hepatic status before and after HSCT.

Comparison between Two-Dimensional and Point Shear Wave Elastography Techniques in Evaluating Liver Fibrosis Using Histological Staging as the Reference Standard: A Prospective Pilot Study.

Evaluation of hepatic fibrosis is essential to prevent liver-related morbidity and mortality. Although various types of ultrasound shear wave elastography (SWE) have been used and validated, there are limited studies on the relatively newer technique, two-dimensional SWE (2D-SWE). Therefore, this study aimed to compare the diagnostic performances of 2D-SWE and point SWE (p-SWE) for evaluating liver fibrosis using histology as the reference standard. To measure liver stiffness (LS) values, 87 patients underwent 2D-SWE and p-SWE using the same machine. Technical failures and unreliable measurements were also evaluated. The diagnostic performances of 2D-SWE and p-SWE were compared using area under the receiver operating characteristic (AUROC) curve analysis. No technical failures were observed in either method; however, unreliable measurements were less frequent in 2D-SWE (1/87 [1.1%]) than in p-SWE (8/87 [9.2%]) (p < 0.001). The AUROC of the LS values of 2D-SWE were significantly higher than those of p-SWE for diagnosing significant fibrosis (0.965 vs. 0.872, p = 0.022) and cirrhosis (0.994 vs. 0.886, p = 0.042). In conclusion, 2D-SWE is more reliable and accurate than p-SWE for diagnosing hepatic fibrosis.

Evaluation of Hepatic Fibrosis Using Ultrasound Backscattered Radiofrequency Signals and One-Dimensional Convolutional Neural Networks.

The early detection of hepatic fibrosis is of critical importance. Ultrasound backscattered radiofrequency signals from the liver contain abundant information about its microstructure. We proposed a method for characterizing human hepatic fibrosis using one-dimensional convolutional neural networks (CNNs) based on ultrasound backscattered signals. The proposed CNN model was composed of four one-dimensional convolutional layers, four one-dimensional max-pooling layers, and four fully connected layers. Ultrasound radiofrequency signals collected from 230 participants (F0: 23; F1: 46; F2: 51; F3: 49; F4: 61) with a 3-MHz transducer were analyzed. Liver regions of interest (ROIs) that contained most of the liver ultrasound backscattered signals were manually delineated using B-mode images reconstructed from the backscattered signals. ROI signals were normalized and augmented by using a sliding window technique. After data augmentation, the radiofrequency signal segments were divided into training sets, validation sets and test sets at a ratio of 80%:10%:10%. In the test sets, the proposed algorithm produced an area under the receive operating characteristic curve of 0.933 (accuracy: 91.30%; sensitivity: 92.00%; specificity: 90.48%), 0.997 (accuracy: 94.29%; sensitivity: 94.74%; specificity: 93.75%), 0.818 (accuracy: 75.00%; sensitivity: 69.23%; specificity: 81.82%), and 0.934 (accuracy: 91.67%; sensitivity: 88.89%; specificity: 94.44%) for diagnosis liver fibrosis stage ≥F1, ≥F2, ≥F3, and ≥F4, respectively. Experimental results indicated that the proposed deep learning algorithm based on ultrasound backscattered signals yields a satisfying performance when diagnosing hepatic fibrosis stages. The proposed method may be used as a new quantitative ultrasound approach to characterizing hepatic fibrosis.

Evaluation of Hepatic Fibrosis by Fibroscan® in Infections Chronic HbeAg Negative

Introduction: The Fibroscan® is a non-invasive test that assesses liver fibrosis by measuring the degree of liver elasticity. It occupies an important place in the evaluation of hepatic fibrosis in patients with chronic liver disease.The aim is to evaluate the interest of Fibroscan® in the evaluation of hepatic fibrosis in chronic HbeAg negative infections. Materials and methods: All patients with a chronic HbeAg negative infection from April 2019 to June 2022 were included. Chronic HbeAg negative infection is defined by: a normal clinical examination, a normal abdominal ultrasound, normality of transaminases at several times, AgHbs positive, AgHbe negative, and viral DNA less than 2000 IU/ml on quarterly monitoring over 1 year. The interpretation of the Fibroscan® results took into account 10 measurements validated by the device with the interquartile range (IQR) &lt; 30% of the median and a success rate &gt; 60%. Results: Out of a total of 753 Fibroscans® performed, 163 patients had a chronic HbeAg negative infection, i.e. 21.6%. The mean age of the patients was 49.6 ± 11.2. We note a female predominance of 52.1% with a sex ratio of 0.9. The median elasticity value was 5.6 Kpa (2.5 – 20 Kpa). Fibrosis was non-significant in 83.3% and fibrosis was significant in 16.6% (moderate fibrosis: 12%; severe: 1.3% and cirrhosis: 3.3%). There was a failure of the fibroscan in 13 patients (7.9%) with a BMI &gt; 35 kg/m2 despite the XL probe. Conclusion: Fibroscan® showed the absence of significant fibrosis in the majority of patients with chronic HbeAg negative infection. It allowed the diagnosis of significant fibrosis and cirrhosis in 16.6% of cases. The fibroscan is an excellent non-invasive examination for the evaluation of fibrosis in chronic HbeAg negative infections.

Comparison of the diagnostic performance of shear wave elastography with shear wave dispersion for pre-operative staging of hepatic fibrosis in patients with hepatocellular carcinoma

PurposeThis prospective study aimed to compare the diagnostic accuracy of shear wave elastography (SWE) with that of shear wave dispersion (SWD) in evaluation of hepatic fibrosis in patients with hepatocellular carcinoma before resection. MethodA total of 210 consecutive patients with hepatocellular carcinoma (HCC) who were scheduled to undergo hepatectomy were prospectively enrolled, pre-operative SWE and SWD examinations were performed. Fibrosis staging and necroinflammatory activity were determined histopathologically according to the Scheuer standard. Multivariate linear regression analysis was used to identify factors associated with SWE and SWD values. The performance of SWE and SWD were determined by receiver operating characteristic (ROC) analysis. ResultsBoth SWE and SWD values of liver were highly correlated with liver fibrosis stage and necroinflammatory activity (p < 0.05). Both SWE and SWD values were significantly different among the patients with different stages of liver fibrosis (p < 0.001). ROC analysis revealed that SWE that predicted substantial fibrosis (S ≥ 2), severe fibrosis (S ≥ 3) and cirrhosis (S = 4) were 0.895, 0.877 and 0.854, the SWD that predicted substantial fibrosis (S ≥ 2), severe fibrosis (S ≥ 3) and cirrhosis (S = 4) were 0.857, 0.815 and 0.791. SWE had better diagnostic performance than SWD in predicting severe fibrosis (S ≥ 3) and cirrhosis (S = 4). ConclusionsBoth SWE and SWD are useful, accurate and non-invasive methods for evaluating hepatic fibrosis in patients with hepatocellular carcinoma adapted to hepatectomy, SWE is a more accurate imaging modality than SWD in predicting severe fibrosis (S ≥ 3) and cirrhosis (S = 4).

Study of golgi protein-7 levels associated cirrhosis in patients with infections hepatitis B virus

Background/Aims: Infection with the hepatitis B virus (HBV) is a major health concern that can lead to liver failure. The hepatitis B virus (HBV) infects humans in both acute and chronic forms. The transmission of this infectious illness is caused by several risk factors. The goal of this study was to look at the epidemiology and risk factors of HBV infection. HBV infection is associated with cirrhosis and/or hepatocellular cancer (HCC). Golgi protein 73(GP73) in human serum is a useful biomarker in the evaluation of hepatic fibrosis, cirrhosis, and hepatocellular carcinoma (HCC) by hepatitis B virus (HBV). The purpose of this study was to evaluate the serum GP73 level's ability to predict HBV infection caused by cirrhosis and/or HCC. Methods: In serum samples, GP73 levels were determined using an enzyme-linked immunosorbent assay (ELISA). This study looked at the underlying function of HBV-induced GP73 in controlling cirrhosis and/or HCC development. ELISA was used to assess hepatitis B surface Antigen (HBsAg) and GP73 expression in HBV-related to cirrhosis and/or hepatocellular cancer (HCC). Results: This study included a total of 35 patients with HBsAg by ELISA technique and 18 persons as control group negative to (HBsAg, anti-HBc-Ab, anti-HCV-Ab, HIV).

Efficacy of Real-Time Tissue Elastography (HI-RTE) for the Evaluation of Hepatic Fibrosis in Patients with Chronic Hepatitis C

Efficacy of Real-Time Tissue Elastography (HI-RTE) for the Evaluation of Hepatic Fibrosis in Patients with Chronic Hepatitis C

Diagnostic Performance of 2-D Shear Wave Elastography on the Evaluation of Hepatic Fibrosis with Emphasis on Impact of the Different Region-of-Interest Methods.

The purpose of this study was to evaluate the impact of the different region-of-interest (ROI) methods of 2-D shear wave elastography (2-D SWE) on hepatic fibrosis diagnosis. In this retrospective study, 83 patients who underwent 2-D SWE with three ROI methods (a circle ROI, a box ROI and multiple ROIs in an elastogram) and transient elastography (TE) were included. Liver stiffness (LS) was measured five times with each ROI method. These LS values were compared, and their correlation with those obtained from TE was evaluated. The LS values obtained using the three different ROI methods differed statistically (p < 0.001). However, the LS values obtained using each ROI method of 2-D SWE were highly correlated with those obtained using TE (r > 0.7, p < 0.001). All three ROI methods of 2-D SWE had high areas under the receiver operating characteristic curve in diagnosing significant fibrosis and cirrhosis (0.841, 0.820 and 0.840, respectively; 0.962, 0.946 and 0.945, respectively). There were no significant differences in area under the receiver operating characteristic curve among the ROI methods of 2-D SWE. Regardless of the ROI method, 2-D SWE had high performance in diagnosing hepatic fibrosis.

Evaluation of hepatic fibrosis in patients with chronic hepatitis B virus by non-invasive methods: Aspartate-to-platelet ratio index, Fibrosis-4, fibrotest and fibroscan

Background: The process of hepatic fibrosis is common to the various etiologies of chronic liver disease such as viral hepatitis B. Objective: To evaluate hepatic fibrosis by non-invasive markers such as Aspartate-to-Platelet Ratio Index (APRI), fibrosis-4 (FIB-4), fibrotest and fibroscan. Patients and Method: This was a descriptive study during a period of 32 months. Included in our study were the records of outpatients, chronic carriers of hepatitis B virus without viral co-infection C, D or HIV, followed in the Gastroenterology unit of the Campus Teaching Hospital of Lome-Togo. Results: We retained 222 patients. Among the patients, 148 patients (66.67%) were classified in Phase 3 (inactive carrying). Only 10 patients (4.50%) had a APRI score indicating a fibrosis stage ≥ F4 (presence of cirrhosis). A FIB-4 score indicating the presence of cirrhosis was found in 12 patients (5.40%). The most represented stage at fibrotest was the F0 stage (45.45%). Cirrhosis was noted in 6.06% of cases at fibroscan. Patients with APRI score ≤ 2 (96.23%) had a FIB-4 score ≤ 3.25, (p = 0.0088). Conclusion: The evaluation of hepatic fibrosis during chronic hepatopathies is essential for patients care because it influences therapeutic decisions.

Evaluation of hepatic fibrosis in patients with chronic hepatitis B virus by non-invasive methods: Aspartate-to-platelet ratio index, Fibrosis-4, fibrotest and fibroscan

Evaluation of hepatic fibrosis in patients with chronic hepatitis B virus by non-invasive methods: Aspartate-to-platelet ratio index, Fibrosis-4, fibrotest and fibroscan

Role of PNPLA3 in the Assessment and Monitoring of Hepatic Steatosis and Fibrosis in Patients with Chronic Hepatitis C Infection Who Achieved a Sustained Virologic Response.

Background and Objectives: Hepatic diseases are an important public health problem. All patients with chronic hepatitis C virus (HCV) infection receive treatment, regardless of hepatic fibrosis severity. However, evaluation of hepatic fibrosis and steatosis is still useful in assessing evolution, prognosis and monitoring of hepatic disease, especially after treatment with direct-acting antivirals (DAAs). The aim of this study was to assess the link between patatin-like phospholipase domain-containing 3 (PNPLA3) polymorphism and the degree of hepatic steatosis and fibrosis in patients with chronic HCV infection, as well as changes in steatosis and fibrosis three monthsafter obtaining a sustained viral response (SVR). Materials and Methods:Ourstudy included 100 patients with chronic hepatitis C (CHC) infection and compensated cirrhosis who received DAA treatment and who were evaluated using Fibromax prior to and 3 months after SVR. The influence of PNPLA3 (CC, CG, GG) genotype among these patients on the degree of post-treatment regression of steatosis and fibrosis was assessed. Results: Regression was noticed in the degree of both hepatic steatosis and hepatic fibrosis post-DAA treatment (three months after SVR). Analysis of the correlation between PNPLA3 genotype and fibrosis indicated that the average level of fibrosis (F) before DAA treatment was higher in patients with the GG genotype than in patients with the CC or CG genotype. Three months after SVR, the average level of fibrosis decreased; however, it remained significantly increased in GG subjects compared to that in CC or CG patients. The degree of hepatic steatosis before treatment was not significantly different among patients with different PNPLA3 genotypes, and no significant correlations were observed three months after SVR. Conclusions: The genetic variants of PNPLA3 influence the evolution of hepatic fibrosis. The GG subtype plays an important role in the degree of hepatic fibrosis both before and after treatment (three months after SVR)and could be a prognostic marker for assessment of post-SVR evolution.

The role of sonoelastography in the evaluation of hepatic fibrosis in pediatric patients

The role of sonoelastography in the evaluation of hepatic fibrosis in pediatric patients

Doppler Ultrasound and Fibroscan Parameters Versus Liver Biopsy ‎in Evaluation of Hepatic Fibrosis in Egyptian Patients with Chronic ‎Hepatitis C‎

Background and study aim: Liver biopsy is the gold standard method to assess hepatic ‎inflammation and fibrosis in chronic hepatitis C infection (HCV). The ‎non-invasive assessment of liver fibrosis is the key target that has ‎inspired many new methods because of the limitations of liver biopsy. ‎The aim of the work was to improve the efficiency of non-invasive liver ‎fibrosis assessment in Egyptian patients with chronic hepatitis C by ‎comparing Doppler ultrasound (US) of hepatic blood flow and ‎fibroscan with liver biopsy‎. Patients and Method: ‎ In this retrospective analysis, 78 patients with HCV had already ‎undergone liver biopsies as part of work panel prior to HCV treatment. ‎Fibroscan examination, abdominal ultrasonography and Doppler ‎ultrasound were done to the patients by experienced operators‎‎.‎ Results: There was a strong positive‏ ‏correlation between the degree of liver ‎fibrosis by fibroscan and the degree of inflammation in the ‎histopathological analysis. Receiver Operator Characteristic (ROC) ‎curve analysis revealed that fibroscan failed to detect FII fibrosis. ‎However, fibroscan was more accurate in detecting FIII ‎fibrosis.The Doppler ultrasound parameter ROC curve analysis, ‎the portal vein blood flow volume (PVBFV) was shown to be ‎more accurate in detecting lower grades of fibrosis than ‎higher‎. Conclusion: For detection higher degrees of fibrosis, Fibroscan has a strong match ‎with liver biopsy; however, Doppler US is more sensitive in detecting ‎lower grades of fibrosis in patients infected with HCV‎ ‎‎‎.

Evaluation of hepatic fibrosis in HIV/HCV co-infected individuals in Yaound\xe9, Cameroon: usefulness of APRI score in resource-constrained settings

BackgroundHIV infection exacerbates the prognosis of HCV infection, with a faster progression of hepatitis. Hepatic fibrosis is the major disruption of the hepatic tissue architecture characterized by anarchic deposition and excess of the extracellular matrix. The objective of this study was to evaluate hepatic fibrosis in HIV/HCV co-infected individuals as compared to HCV mono-infected.MethodsA total of 97 participants (mean age 60.2 ± 14.3 years and 0.76 male/female sex ratio) was enrolled in a study conducted in Yaoundé, Cameroon from November 2018 to January 2019. Liver fibrosis was assessed by the APRI score (Aspartate Aminotransferase or AST/Platelet Ratio Index) which identifies the stage of fibrosis as classified by the Metavir system (F0 to F4). CD4 counts and plasmatic HIV viral load of HIV/HCV co-infected individuals were determined and the correlation between hepatic fibrosis and immuno-virological status established. Statistical analysis was done using Microsoft Excel 2016 and EpiInfo7 software.ResultsA high proportion (63.6%) of HIV/HCV co-infected participants had an abnormal AST level: 73.6 ± 45.8 IU/L as compared to 58.5 ± 39.3 IU/L (59.3%) among HCV mono-infected participants. The frequency of thrombocytopenia was 63.6% with a mean platelet count of 137 ± 50 × 103 IU/L in HIV/HCV co-infected participants as compared to 176 ± 67 × 103 IU/L in HCV mono-infected participants (38.4%). The progression of hepatic fibrosis in participants with clinically significant fibrosis: F2, F3 and F4 was higher among HIV/HCV co-infected and the mean APRI score was 1.7 ± 1.4 versus 1 ± 0.8 among HCV mono-infected (26.7%). All participants (100%) with detectable HIV viral load had clinically significant fibrosis compared to 33.4% in those with undetectable HIV viral load (p = 0.55). Only 42.9% participants with CD4 > 500 cells/μL had clinically significant fibrosis (p = 0.72) while 100% participants with CD4 < 200 cells/μL had clinically significant fibrosis (p = 0.58).ConclusionsA high level of AST combined with thrombocytopenia (APRI score > 1.5) is an indicator of hepatic fibrosis in HIV/HCV co-infected individuals. Because of its non-invasive and less costly nature, the APRI score can be a suitable biomarker to monitor hepatic fibrosis in HIV/HCV co-infected individuals in resource constrained settings.

Corrigendum to: Evaluation of hepatic fibrosis by elastography in patients with schistosomiasis mansoni.

Corrigendum to: Evaluation of hepatic fibrosis by elastography in patients with schistosomiasis mansoni.