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Discordance between conventional ultrasonography and ElastPQ for assessing hepatic fibrosis in chronic hepatitis B: frequency and independent factors

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Abstract

Purpose

To investigate the frequency of discordance and to identify factors associated with discordance between ultrasonographic and elastographic grades for assessing hepatic fibrosis in Asian patients with chronic hepatitis B.

Methods

Three hundred thirty-four patients with chronic hepatitis B for which both conventional ultrasonography and liver stiffness measurements using elastography were available were included. Patients were graded as ‘normal’, ‘chronic liver disease’, or ‘liver cirrhosis’ by ultrasonography, and as ‘no significant fibrosis’, ‘significant fibrosis’, or ‘liver cirrhosis’ by elastography, and the results of these two modalities were compared. Logistic regression analyses were performed to identify independent factors associated with discordant results.

Results

Of the 334 patients, 153 (45.8 %), 115 (34.4 %), and 66 (19.8 %) patients were ‘normal’, ‘chronic liver disease’, and ‘liver cirrhosis’, respectively, based on the ultrasonographic grades, and 290 (86.8 %), 29 (8.7 %), and 15 (4.5 %) patients were ‘no significant fibrosis,’ ‘significant fibrosis’, and ‘liver cirrhosis’, respectively, based on the elastographic values. Among them, 173 (51.8 %) showed discordance with respect to severity of hepatic fibrosis. In multivariable analysis, discordance was more frequent in patients with ultrasonographic grades of ‘chronic liver disease’ [adjusted odds ratio (AOR), 1924; P < 0.001] and ‘liver cirrhosis’ (AOR, 4498; P < 0.001), whereas patients with an elastographic grade of ‘liver cirrhosis’ showed a negative association with discordance (AOR, 0.002; P = 0.007).

Conclusion

There was a high rate of discordance between hepatic fibrosis grades determined by ultrasonography and elastography. Considering the accuracy of liver stiffness evaluation by elastography, conventional ultrasonography might overestimate hepatic fibrosis in chronic hepatitis B.

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Acknowledgments

We thank Miyeon Lee for assisting with the statistical analysis for this study.

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Authors and Affiliations

  1. Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Mi Sung Kim, Heon-Ju Kwon, Hae Won Park, Hee-Jin Park, Hyun Pyo Hong & Myung Ho Rho

  2. Department of Gastroenterology and Hepatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Byung Ik Kim

  3. Department of Gastroenterology and Hepatology, Dankook University Hospital, 108 Pyong dong, Jongro-gu, Seoul, 110-746, Korea

    Ki Bae Bang

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  1. Mi Sung Kim
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  2. Byung Ik Kim
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  5. Hee-Jin Park
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  7. Hyun Pyo Hong
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Correspondence to Mi Sung Kim.

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There are no financial or other relations that could lead to a conflict of interest.

Ethical considerations

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was waived.

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Kim, M.S., Kim, B.I., Kwon, HJ. et al. Discordance between conventional ultrasonography and ElastPQ for assessing hepatic fibrosis in chronic hepatitis B: frequency and independent factors. J Med Ultrasonics 43, 201–210 (2016). https://doi.org/10.1007/s10396-015-0684-7

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  • DOI: https://doi.org/10.1007/s10396-015-0684-7

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