La radiologia medica

, Volume 123, Issue 10, pp 735–741 | Cite as

Analysis of three ultrasound elastography techniques for grading liver fibrosis in patients with chronic hepatitis B

  • Xinping Ren
  • Shujun Xia
  • Zhongxin Ni
  • Weiwei ZhanEmail author
  • Jianqiao ZhouEmail author



Evaluation of liver fibrosis is important to assess prognosis and guide the treatment for chronic hepatitis B.


To analyze and compare transient, point, and two-dimensional (2D) shear wave elastography techniques in grading the liver fibrosis.


Based on the severity of liver inflammation and fibrosis (Scheuer criteria), 158 patients with chronic hepatitis B were assigned into group 1 (either G or S classification < 2) or group 2 (either G or S classification ≥ 2). Group 2 patients commonly require anti-viral treatment. All patients received transient (FibroScan), point (STQ), and 2D (STE) elastography examinations. Receiver operating characteristic curves were calculated from three elastography techniques in individual or in combination.


A total of 158 patients were enrolled into the study, with 39.2% (62) female and mean age of 42.8 (standard deviation 19.1) years old. Transient elastography could not differentiate between group 1 and group 2 patients (P = 0.12), whereas point and 2D elastography examinations could distinguish patients in group 1 from group 2 (P < 0.01 for both STQ and STE). Administration of combined three elastography techniques showed the best diagnostic accuracy (90.1%) for liver fibrosis, which was confirmed with hepatic biopsy examination.


Point and 2D elastography were superior to transient elastography to detect liver fibrosis and guide clinical anti-viral treatment. Analysis of combined transient, point, and 2D elastography techniques showed the better diagnostic accuracy for liver fibrosis.


Chronic hepatitis B Liver fibrosis Transient elastography Point elastography Two-dimensional elastography 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of Ruijin Hospital, Shanghai Jiaotong University School of Medicine.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Italian Society of Medical Radiology 2018

Authors and Affiliations

  1. 1.Ultrasonic Department, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina

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