Clinical value of real-time elastography quantitative parameters in evaluating the stage of liver fibrosis and cirrhosis

Abstract

Abstract. The aim of the present study was to assess the value of real-time elastography (RTE) quantitative parameters, namely the liver fibrosis (LF) index and the ratio of blue area (%AREA), in evaluating the stage of liver fibrosis. RTE quantitative analysis software was used to examine 120 patients with chronic hepatitis in order to obtain the values for 12 quantitative parameters from the elastic images. The diagnostic performance of two such parameters, the LF index and %AREA, were assessed with a receiver operating characteristic (ROC) curve to determine the optimal diagnostic cut-off values for liver cirrhosis and fibrosis. A good correlation was observed between the LF index and %AREA with the fibrosis stage. The areas under the ROC curve for the LF index were 0.985 for the diagnosis of liver cirrhosis and 0.790 for liver fibrosis. With regard to %AREA, the areas under the ROC curve for the diagnosis of liver cirrhosis and fibrosis were 0.963 and 0.770, respectively. An LF index of >3.25 and a %AREA of >28.83 for the diagnosis of cirrhosis stage resulted in sensitivity values of 100 and 100%, specificity values of 88.9 and 85.9% and accuracy values of 90.8 and 88.3%, respectively. The LF index and %AREA parameters exhibited higher reliability in the diagnosis of liver cirrhosis compared with the diagnosis of the liver fibrosis stage. However, the two parameters possessed a similar efficacy in the diagnosis of liver cirrhosis and the stage of liver fibrosis. Therefore, the quantitative RTE parameters of the LF index and %AREA may be clinically applicable as reliable indices for the early diagnosis of liver cirrhosis, without the requirement of an invasive procedure.

Could semiquantitative analysis of real-time ultrasound elastography distinguish more liver parenchyma alterations of nonalcoholic fatty liver disease in patients with polycystic ovary syndrome?

“…Our research confirmed that MEAN decreases in PCOS with NAFLD, while AREA and SD increase as compared to PCOS without NAFLD and healthy controls; these results are in agreement with other studies (12,16,17,29). This finding may be explained theoretically as follows: a softer tissue can be compressed more easily than a stiffer tissue; thus, the displacement of the reflected ultrasound echoes (MEAN) is smaller in the stiffer tissue.…”

“…There is intrinsic relevance among all the 11 semiquantitative strain parameters. Several authors developed different scoring systems based on the parameters calculated with different formulas, and currently there is no consensus (17,18). In this study, we analyzed only the main parameters including MEAN, AREA, and SD, especially MEAN.…”

“…With the improvements in RTE, semiquantitative analysis of strain was developed. Parameters including the average strain value (MEAN) of RTE are reported to be useful for early diagnosis and staging of liver fibrosis (12)(13)(14)(15)(16)(17)(18).…”

Clinical Significance of Preoperative Liver Stiffness Measurements in Primary HBV-Positive Hepatocellular Carcinoma

“…It was revealed in this study that LSM value was significantly associated with liver cirrhosis diagnosis. In a clinical setting, liver cirrhosis always has been confirmed based on ultrasonography, laboratory test and radiology imaging, and its accuracy can hardly be evaluated by quantification analysis [34]. Furthermore, the influence of liver cirrhosis may have been confounded, because liver cirrhosis was analyzed as a single category without considering the wide-range severity of liver cirrhosis.…”

Current role of transient elastography in the management of chronic hepatitis B patients

“…Not many studies have been performed of the usefulness of RTE in CHB patients. A study of 111 CHB patients suggested a liver fibrosis index of >3.25 and a % area of >28.83% for the diagnosis of cirrhosis, with 100% sensitivity and 85.9% specificity [83]. RTE can be used in patients with ascites or severe obesity.…”