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Non-invasive assessment of liver fibrosis in patients with alcoholic liver disease using acoustic radiation force impulse elastography

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Abstract

Objectives

To investigate the diagnostic performance of the acoustic radiation force impulse (ARFI) elastography for the assessment of the liver fibrosis in alcoholic liver disease (ALD).

Methods

We included 112 patients with ALD in whom liver biopsy, ARFI elastography, and aspartate-to-platelet ratio index (APRI) measurements were performed.

Results

ARFI elastography correlated significantly with histological fibrosis (r = 0.685, P < 0.001) in patients with ALD. The diagnostic accuracies expressed as areas under receiver operating characteristic (AUROC) curves for ARFI elastography and APRI were 0.846 and 0.763 for the diagnosis of significant fibrosis (S ≥ 2), 0.875 and 0.688 for the diagnosis of severe fibrosis (S ≥ 3), and 0.893 and 0.648 for the diagnosis of liver cirrhosis, respectively. The AUROC values of ARFI elastography were significantly better than those of APRI for predicting severe fibrosis (P = 0.02) and cirrhosis (P = 0.04). The optimum cutoff values for ARFI elastography were 1.33 m/s for S ≥ 2, 1.40 m/s for S ≥ 3, and 1.65 m/s for S = 4 in patients with elevated alanine aminotransferase (ALT) levels; these decreased to 1.24 m/s for S ≥ 2, 1.27 m/s for S ≥ 3, and 1.41 m/s for S = 4 in patients with normal ALT.

Conclusion

ARFI elastography is an acceptable method for predicting the severity of fibrosis in patients with ALD. ARFI elastography is influenced by elevated aminotransferase levels in ALD.

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Author information

Authors and Affiliations

  1. Department of Ultrasound, The 302 Hospital of PLA, No. 100, Xi Si Huan Zhong Lu, Beijing, 100039, China

    Dakun Zhang, Min Chen, Yang Liu & Ruifang Wang

  2. Second Clinic Department, Peking University School of Stomatology, Beijing, 100101, China

    Peng Li

  3. Department of Ultrasound, The First Hospital Affiliated to Shanxi Medical University, Taiyuan, 030001, China

    Liping Liu

  4. Department of Ultrasound, Qi Lu Hospital (Qing dao), Shandong University, Qingdao, 266000, China

    Yuanyuan Zhao

Authors
  1. Dakun Zhang
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  2. Peng Li
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  3. Min Chen
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  4. Liping Liu
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  5. Yang Liu
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  6. Yuanyuan Zhao
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  7. Ruifang Wang
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Corresponding author

Correspondence to Dakun Zhang.

Additional information

Dakun Zhang and Peng Li have contributed equally to this work.

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Cite this article

Zhang, D., Li, P., Chen, M. et al. Non-invasive assessment of liver fibrosis in patients with alcoholic liver disease using acoustic radiation force impulse elastography. Abdom Imaging 40, 723–729 (2015). https://doi.org/10.1007/s00261-014-0154-5

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  • DOI: https://doi.org/10.1007/s00261-014-0154-5

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