Transient Elastography Identifies the Risk of Esophageal Varices and Bleeding in Patients With Hepatitis B Virus–Related Liver Cirrhosis

Zhu, Qingjing; Zhao, Jinfang; Alasbahi, Afnan; Huang, Ying; Du, Fang; Zhou, Jianning; Song, Yufang; Xu, Ke; Ye, Jin; Yang, Ling

doi:10.1097/ruq.0000000000000373

Cited by 9 publications

(7 citation statements)

References 23 publications

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“… 20 After years of application and development, transient elastography (TE) and shear-wave elastography are now relatively accepted in clinical practice. 21 , 22 However, TE still needs to improve due to the problem of a lack of image guidance. ViTE is the latest elastography technology, which can combine 2D images and transient elastography simultaneously on a single probe.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Visual Transient Elastography and Shear Wave Elastography in Evaluating Liver Fibrosis in Patients with Chronic Liver Disease

Yang¹,

Li²,

Ye³

et al. 2021

IJGM

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This study investigated the effectiveness and feasibility of shear wave elastography ((sound touch elastography) STE and (shear wave elastography) SWE) and visual transient elastography (ViTE) in the noninvasive quantitative diagnosis of liver fibrosis in chronic liver disease (CLD). Patients and Methods: A total of 106 patients with CLD underwent STE, SWE and ViTE elastography evaluation. The Young's modulus of the three elastography was valuated and the diagnostic performances of the three techniques for liver fibrosis staging were compared. The area under the receiver operating curve (ROC) for the diagnosis of liver fibrosis was compared. The final diagnosis was based on the histological findings on the liver biopsy. Results: 1) The correlation between ViTE and SWE, ViTE and STE, SWE and STE stiffness values were 0.72, 0.75, 0.75 (P<0.001). 2) The relationship between the results of each elastography technique and the stage of pathological liver fibrosis showed that the more severe the liver fibrosis was, the higher the stiffness value was (all P <0.001). 3) When the three elastography techniques were used to detect the degree of liver fibrosis in different pathological stages, there was no statistical difference in the stabilities of the boxplots. 4) The ROCs of the three elastography techniques (ViTE, SWE and STE) were 0.

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Section: Discussionmentioning

confidence: 99%

Comparison of Visual Transient Elastography and Shear Wave Elastography in Evaluating Liver Fibrosis in Patients with Chronic Liver Disease

Yang¹,

Li²,

Ye³

et al. 2021

IJGM

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“…[27][28][29] Significant correlations between liver stiffness by TE of EVs and hepatic hypertension have been found. 8,30,31 However, TE has several technical limitations in patients with a high BMI, ascites, increased bilirubin or transaminase, extrahepatic cholestasis, and heart failure with high technical failure rates. 32,33 Here, we applied the new technology SWE to measure liver stiffness, which enables a better determination of overall liver fibrosis distribution and avoids the influence of the complications of cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies recommend that the measurement of liver stiffness by TE is a useful noninvasive modality in monitoring liver cirrhosis and its complications 27–29 . Significant correlations between liver stiffness by TE of EVs and hepatic hypertension have been found 8,30,31 . However, TE has several technical limitations in patients with a high BMI, ascites, increased bilirubin or transaminase, extrahepatic cholestasis, and heart failure with high technical failure rates 32,33 …”

Section: Discussionmentioning

confidence: 99%

Liver Stiffness Detected by Shear Wave Elastography Predicts Esophageal Varices in Cirrhotic Patients

Xiong

Yuan

Aiyun

2019

Ultrasound Quarterly

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Ultrasound elastography has become a promising noninvasive approach for assessing liver fibrosis. The purpose of this study was to evaluate the diagnosis ability of liver stiffness detected by shear wave elastography (SWE) for predicting the presence of esophageal varices (EVs) in cirrhotic patients. Four hundred sixty-eight cirrhotic patients were enrolled consecutively. Liver stiffness and EVs were detected by SWE and endoscopy, respectively. The baseline characteristics were recorded, and areas under the receiver operating characteristic curves (AUROCs) were used to compare the diagnosis accuracy. Multivariate analysis was used to identify the risk factors for EVs in cirrhosis. The mean liver stiffness was 18.4 kPa with a range of 6.8 to 52.5 kPa. Two hundred seventy-one patients had no EVs (57.9%), 139 patients had F1 EVs (29.7%), and 58 patients had high-risk EVs (12.4%). The optimal cutoff values of SWE for predicting EVs and high-risk varices were 18.5 and 20.4 kPa, respectively. The AUROCs for predicting the incidence of EVs were 0.792 (95% confidence interval [CI], 0.884-0.842), 0.814 (95% CI, 0.658-0.875), and 0.895 (95% CI, 0.813-0.918) for platelet, platelet count-to-spleen diameter ratio, and liver stiffness, respectively. For predicting the presence of high-risk varices, liver stiffness again had the highest AUROC. Multivariate analysis identified liver stiffness and platelet count-to-spleen diameter ratio as independent predictive factors for EVs in cirrhosis. Liver stiffness measured by SWE is an effective diagnostic tool for predicting EVs with greater accuracy, and SWE value is an independent factor for predicting high-risk EVs.

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“…Although imaging methods require specialized training and experience, they are considered the most well‐validated non‐invasive techniques for assessing liver fibrosis. Among these, SWE and TE are accepted and FDA‐approved elastographic modalities for measuring liver stiffness 25,26 . In our study, we employed SWE for assessing liver stiffness in 53 participants and TE in 23 participants because of equipment availability.…”

Section: Discussionmentioning

confidence: 99%

Suboptimal reliability of FIB‐4 and NAFLD‐fibrosis scores for staging of liver fibrosis in general population

Hazzan,

Abu Ahmad,

Habib

et al. 2024

JGH Open

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Background and AimThe burden and incidence of liver cirrhosis are increasing worldwide. Early detection of liver fibrosis would help in early interventions and preventing the progression of fibrosis and cirrhosis. The accepted noninvasive markers for liver fibrosis staging, namely fibrosis‐4 (FIB‐4) and nonalcoholic fatty liver disease fibrosis score (NFS), have shown inconsistent performance for detecting the fibrosis stage. We aimed to evaluate the efficacy of FIB‐4 score and NFS for the detection of liver fibrosis in the general population.MethodsFrom a general population referred from a single, community‐based family‐physician clinic, we included study participants between the ages of 45 and 65 years, with no knowledge of liver disease and no record of alcohol consumption. Liver fibrosis was evaluated by the FIB‐4 score and NFS using shear wave elastography (SWE) or transient elastography (TE) measurements as a reference.ResultsA total of 76 participants (aged 61.5 ± 0.37 years, 33% females) were included in the study cohort. We observed a nonsignificant correlation between liver stiffness measurement (LSM) and FIB‐4 and NFS (r = 0.1, P = 0.37; r = 0.16, P = 0.15, respectively). Our results showed that only 5.2% with FIB‐4 >3.25 and 9.7% with NFS >0.675 had LSM >12 kPa. The compatibility of fibrosis staging was 55% between FIB‐4 score and LSM and only 18% between NFS and LSM.ConclusionWe found that FIB‐4 and NFS are unreliable tools for liver fibrosis estimation in the general population. There is a need for more reliable noninvasive methods for the early detection of liver fibrosis.

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Transient Elastography Identifies the Risk of Esophageal Varices and Bleeding in Patients With Hepatitis B Virus–Related Liver Cirrhosis

Cited by 9 publications

References 23 publications

Comparison of Visual Transient Elastography and Shear Wave Elastography in Evaluating Liver Fibrosis in Patients with Chronic Liver Disease

Comparison of Visual Transient Elastography and Shear Wave Elastography in Evaluating Liver Fibrosis in Patients with Chronic Liver Disease

Liver Stiffness Detected by Shear Wave Elastography Predicts Esophageal Varices in Cirrhotic Patients

Suboptimal reliability of FIB‐4 and NAFLD‐fibrosis scores for staging of liver fibrosis in general population

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