Diagnostic value of optimised real-time sonoelastography in the assessment of liver fibrosis in chronic hepatitis B and C

• Main Authors: Katarzyna Kalita, Krzysztof Filipczak, Małgorzata Bieńkiewicz, Wojciech Deroń, Zbigniew Deroń, Anna Piekarska, Anna Płachcińska, Jacek Kuśmierek
• Format: Article
• Language: English
• Published: Termedia Publishing House 2016-07-01
• Series: Gastroenterology Review
• Subjects: liver fibrosis; real-time sonoelastography; mean stiffness fraction; intrinsic stiffness ratio
• Online Access: https://www.termedia.pl/Diagnostic-value-of-optimised-real-time-sonoelastography-in-the-assessment-of-liver-fibrosis-in-chronic-hepatitis-B-and-C,41,28069,1,1.html

Aim : To optimise the method of real-time elastography (RTE) in the assessment of liver fibrosis using an in-house prepared method for elastogram analysis, as well as a semiquantitative analysis based on newly introduced parameters. Material and methods : Sonoelastography was performed in 94 patients with various degrees of liver fibrosis and also in 25 healthy volunteers. As a reference method for diagnostic efficacy of sonoelastography-based parameters used for the assessment of fibrosis degree in patients with chronic B and C hepatitis, a liver biopsy was used. Patient’s elastograms were analysed using in-house prepared software, Pixel Count, calculating two semiquantitative parameters: mean stiffness fraction (MSF%) and intrinsic stiffness ratio (ISR). Results: Statistically significant differences between distributions of the above presented parameters for different degrees of liver fibrosis were revealed. Indices of diagnostic efficacy for detection of significant liver fibrosis (F ≥ 2) using MSF% amounted to: sensitivity – 76%, specificity – 87% and ISR: 81% and 87%, respectively. Sensitivity of both parameters in detection of cirrhosis (F = 4) was equal to 88% and specificity amounted to: for MSF% – 84% and ISR – 86%. Interobserver reproducibility determined for both of the above parameters was high, intraclass correlation coefficients (ICC) were 0.91 for MSF% and 0.93 for ISR. Conclusions : Real-time elastography applied in this study, using in-house prepared Pixel Count software, provided good reproducibility and diagnostic efficacy, especially specificity, in the assessment of liver fibrosis degree.