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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 Zhan
  • Jianqiao Zhou
ABDOMINAL RADIOLOGY
  • 91 Downloads

Abstract

Background

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

Objective

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

Methods

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.

Results

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.

Conclusion

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.

Keywords

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

Notes

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.

References

  1. 1.
    Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ (2015) Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet 386:1546–1555CrossRefGoogle Scholar
  2. 2.
    Wright TL (2006) Introduction to chronic hepatitis B infection. Am J Gastroenterol 101(Suppl 1):S1–S6CrossRefGoogle Scholar
  3. 3.
    Calvaruso V, Craxi A (2014) Regression of fibrosis after HBV antiviral therapy. Is cirrhosis reversible? Liver Int 34(Suppl 1):85–90CrossRefGoogle Scholar
  4. 4.
    Friedman SL, Bansal MB (2006) Reversal of hepatic fibrosis—fact or fantasy? Hepatology 43:S82–S88CrossRefGoogle Scholar
  5. 5.
    Pinzani M, Vizzutti F (2008) Fibrosis and cirrhosis reversibility: clinical features and implications. Clin Liver Dis 2:901–913CrossRefGoogle Scholar
  6. 6.
    Sarin SK, Kumar M, Lau GK et al (2016) Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update. Hepatol Int 10:1–98CrossRefGoogle Scholar
  7. 7.
    Kose S, Ersan G, Tatar B, Adar P, Sengel BE (2015) Evaluation of percutaneous liver biopsy complications in patients with chronic viral hepatitis. Eurasian J Med 47:161–164CrossRefGoogle Scholar
  8. 8.
    Cosgrove D, Piscaglia F, Bamber J et al (2013) EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 2: clinical applications. Ultraschall Med 34:238–253CrossRefGoogle Scholar
  9. 9.
    Sigrist RMS, Liau J, Kaffas AE, Chammas MC, Willmann JK (2017) Ultrasound elastography: review of techniques and clinical applications. Theranostics 7:1303–1329CrossRefGoogle Scholar
  10. 10.
    Barr RG, Ferraioli G, Palmeri ML et al (2016) Elastography assessment of liver fibrosis: society of radiologists in ultrasound consensus conference statement. Ultrasound Q 32:94–107CrossRefGoogle Scholar
  11. 11.
    Gerber L, Kasper D, Fitting D et al (2015) Assessment of liver fibrosis with 2-D shear wave elastography in comparison to transient elastography and acoustic radiation force impulse imaging in patients with chronic liver disease. Ultrasound Med Biol 41:2350–2359CrossRefGoogle Scholar
  12. 12.
    Zeng J, Zheng J, Huang Z et al (2017) Comparison of 2-D shear wave elastography and transient elastography for assessing liver fibrosis in chronic hepatitis B. Ultrasound Med Biol 43:1563–1570CrossRefGoogle Scholar
  13. 13.
    Poynard T, Pham T, Perazzo H et al (2016) Real-time shear wave versus transient elastography for predicting fibrosis: applicability, and impact of inflammation and steatosis. A non-invasive comparison. PLoS ONE 11:e0163276CrossRefGoogle Scholar
  14. 14.
    Ferraioli G, Tinelli C, Lissandrin R et al (2014) Point shear wave elastography method for assessing liver stiffness. World J Gastroenterol 20:4787–4796CrossRefGoogle Scholar
  15. 15.
    Paul SB, Das P, Mahanta M et al (2017) Assessment of liver fibrosis in chronic hepatitis: comparison of shear wave elastography and transient elastography. Abdom Radiol (NY) 42:2864–2873CrossRefGoogle Scholar
  16. 16.
    Zhuang Y, Ding H, Zhang Y, Sun H, Xu C, Wang W (2017) Two-dimensional shear-wave elastography performance in the noninvasive evaluation of liver fibrosis in patients with chronic hepatitis B: comparison with serum fibrosis indexes. Radiology 283:873–882CrossRefGoogle Scholar
  17. 17.
    Scheuer PJ (1991) Classification of chronic viral hepatitis: a need for reassessment. J Hepatol 13:372–374CrossRefGoogle Scholar
  18. 18.
    Sandrin L, Fourquet B, Hasquenoph JM et al (2003) Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound Med Biol 29:1705–1713CrossRefGoogle Scholar
  19. 19.
    Bercoff J, Tanter M, Fink M (2004) Supersonic shear imaging: a new technique for soft tissue elasticity mapping. IEEE Trans Ultrason Ferroelectr Freq Control 51:396–409CrossRefGoogle Scholar
  20. 20.
    Xiao G, Zhu S, Xiao X, Yan L, Yang J, Wu G (2017) Comparison of laboratory tests, ultrasound, or magnetic resonance elastography to detect fibrosis in patients with nonalcoholic fatty liver disease: a meta-analysis. Hepatology 66:1486–1501CrossRefGoogle Scholar
  21. 21.
    Bhat M, Tazari M, Sebastiani G (2017) Performance of transient elastography and serum fibrosis biomarkers for non-invasive evaluation of recurrent fibrosis after liver transplantation: a meta-analysis. PLoS ONE 12:e0185192CrossRefGoogle Scholar
  22. 22.
    Geng XX, Huang RG, Lin JM, Jiang N, Yang XX (2016) Transient elastography in clinical detection of liver cirrhosis: a systematic review and meta-analysis. Saudi J Gastroenterol 22:294–303CrossRefGoogle Scholar
  23. 23.
    Venkatesh SK, Ehman RL (2014) Magnetic resonance elastography of liver. Magn Reson Imaging Clin N Am 22:433–446CrossRefGoogle Scholar

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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