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Liver stiffness measurement using acoustic radiation force impulse (ARFI) elastography and effect of necroinflammation.

 Ki Tae Yoon  ;  Sun Min Lim  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Kwang-Hyub Han  ;  Chae Yoon Chon  ;  Mong Cho  ;  Jun Woo Lee  ;  Seung Up Kim 
 DIGESTIVE DISEASES AND SCIENCES, Vol.57(6) : 1682-1691, 2012 
Journal Title
Issue Date
Adult ; Aged ; Aspartate Aminotransferases/analysis ; Aspartate Aminotransferases/metabolism* ; Biopsy, Needle ; Cohort Studies ; Elasticity Imaging Techniques/methods* ; Female ; Follow-Up Studies ; Hepatitis/pathology ; Humans ; Immunohistochemistry ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/pathology* ; Male ; Middle Aged ; Necrosis/pathology ; Prospective Studies ; Risk Assessment ; Sensitivity and Specificity ; Severity of Illness Index
Acoustic radiation force impulse elastography ; Aspartate aminotransferase-to-platelet ratio index ; Chronic liver disease ; Fibroscan ; Fibrosis ; Liver stiffness ; Transient elastography ; Cirrhosis
BACKGROUND: Acoustic radiation force impulse (ARFI) elastography can be used to assess the degree of liver fibrosis. AIM: We evaluated the performance of ARFI elastography in assessment of liver fibrosis and compared it with the performance of aspartate aminotransferase-to-platelet ratio index (APRI) and transient elastography with Fibroscan (FS). METHODS: We prospectively analyzed 250 consecutive patients who underwent liver biopsy and ARFI from June 2010 to May 2011. Reliable FS values were obtained for 97 (38.8%) patients. RESULTS: The mean age of patients (147 male and 103 female) was 46.6 years. Liver stiffness values obtained by use of ARFI elastography significantly correlated with histological fibrosis stage (R = 0.575, P < 0.001). Area under the receiver operating characteristics curves (AUROCs) of ARFI elastography for predicting significant fibrosis (≥F2) and cirrhosis (F4) was 0.74 (95% confidence interval [CI], 0.64-0.86, P = 0.001) and 0.79 (95% CI, 0.67-0.91, P = 0.001), respectively, and those for APRI were 0.69 (95% CI, 0.58-0.79, P = 0.001) and 0.76 (95% CI, 0.64-0.85, P < 0.001), respectively. The optimum cutoff values for ARFI elastography were 1.13 m/s for ≥F2 and 1.98 m/s for F4; these decreased to 1.09 m/s for ≥F2 and 1.81 m/s for F4 when 131 patients with normal alanine aminotransferase (ALT) were selected. In the sub-group of 97 patients with reliable FS values, the performance in predicting ≥F2 or F4 was equivalent between ARFI elastography and FS. CONCLUSIONS: ARFI elastography is a reliable surrogate marker of liver fibrosis, if its relationship with biochemical markers, for example ALT level, is taken into account.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lim, Sun Min(임선민)
Chon, Chae Yoon(전재윤)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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