만성 바이러스간염 환자에서 간탄력도 측정을 이용한 간섬유화 진단

Abstract

Background/Aims: FibroScan(R) is a new medical device that noninvasively measures liver stiffness. The aim of this study was to assess the accuracy of the liver stiffness measurement by FibroScan(R) for making the diagnosis of liver fibrosis in patients with chronic viral hepatitis. Methods: We studied 103 patients with chronic viral hepatitis B or C and they underwent FibroScan(R) and liver biopsy between October 2005 and August 2006. Liver fibrosis was staged on a 0-4 scale according to the Korean Society of Pathologists Scoring System. The diagnostic accuracy was assessed by analysis of the receiver operator characteristics (ROC). Results: The liver stiffness was 3.5-57.1 kPa (mean: 11.8, SD: 8.9). The mean value of liver stiffness in each fibrosis stage group (F1, F2, F3 and F4) was 5.8±1.8 kPa, 11.3±6.8 kPa, 11.8±6.0 kPa and 23.4±16.5 kPa, respectively. Liver stiffness measured by FibroScan(R) showed reliable correlation with the liver fibrosis stage as confirmed by liver biopsy (r=0.56, p<0.001). The AUROC (95% CI) of ≥ F2, ≥ F3 and F4 was 0.93 (0.86-0.99), 0.72 (0.62-0.82) and 0.80 (0.67-0.92), respectively. The sensitivity and specificity of 7.5 kPa, which was the cutoff value for ≥ F2, was 84% and 90%, respectively. Conclusions: FibroScan(R) is a reliable method for the diagnosis of significant fibrosis (≥ F2) and cirrhosis in patients with chronic liver disease. The liver stiffness measurement by FibroScan(R) showed good diagnostic performance for significant fibrosis.