BACKGROUND: Transient elastography (FibroScan) is a new, non-invasive, rapid, and reproducible method allowing evaluation of liver fibrosis by measurement of liver stiffness. In cirrhotic patients, liver stiffness measurements range from 12.5 to 75.5 kPa. However, the clinical relevance of these values is unknown. The aim of this prospective study was to evaluate the accuracy of liver stiffness measurement for the detection of cirrhosis in patients with chronic liver disease. METHODS: A total of 711 patients with chronic liver disease were studied. Aetiologies of chronic liver diseases were hepatitis C virus or hepatitis B virus infection, alcohol, non-alcoholic steatohepatitis, other, or a combination of the above aetiologies. Liver fibrosis was evaluated according to the METAVIR score. RESULTS: Stiffness was significantly correlated with fibrosis stage (r=0.73, p<0.0001). Areas under the receiver operating characteristic curve (95% confidence interval) were 0.80 (0.75-0.84) for patients with significant fibrosis (F>2), 0.90 (0.86-0.93) for patients with severe fibrosis (F3), and 0.96 (0.94-0.98) for patients with cirrhosis. Using a cut off value of 17.6 kPa, patients with cirrhosis were detected with a positive predictive value and a negative predictive value (NPV) of 90%. Liver stiffness was significantly correlated with clinical, biological, and morphological parameters of liver disease. With an NPV>90%, the cut off values for the presence of oesophageal varices stage 2/3, cirrhosis Child-Pugh B or C, past history of ascites, hepatocellular carcinoma, and oesophageal bleeding were 27.5, 37.5, 49.1, 53.7, and 62.7 kPa, respectively. CONCLUSION: Transient elastography is a promising non-invasive method for detection of cirrhosis in patients with chronic liver disease. Its use for the follow up and management of these patients could be of great interest and should be evaluated further.
BACKGROUND: Transient elastography (FibroScan) is a new, non-invasive, rapid, and reproducible method allowing evaluation of liver fibrosis by measurement of liver stiffness. In cirrhotic patients, liver stiffness measurements range from 12.5 to 75.5 kPa. However, the clinical relevance of these values is unknown. The aim of this prospective study was to evaluate the accuracy of liver stiffness measurement for the detection of cirrhosis in patients with chronic liver disease. METHODS: A total of 711 patients with chronic liver disease were studied. Aetiologies of chronic liver diseases were hepatitis C virus or hepatitis B virus infection, alcohol, non-alcoholic steatohepatitis, other, or a combination of the above aetiologies. Liver fibrosis was evaluated according to the METAVIR score. RESULTS: Stiffness was significantly correlated with fibrosis stage (r=0.73, p<0.0001). Areas under the receiver operating characteristic curve (95% confidence interval) were 0.80 (0.75-0.84) for patients with significant fibrosis (F>2), 0.90 (0.86-0.93) for patients with severe fibrosis (F3), and 0.96 (0.94-0.98) for patients with cirrhosis. Using a cut off value of 17.6 kPa, patients with cirrhosis were detected with a positive predictive value and a negative predictive value (NPV) of 90%. Liver stiffness was significantly correlated with clinical, biological, and morphological parameters of liver disease. With an NPV>90%, the cut off values for the presence of oesophageal varices stage 2/3, cirrhosisChild-Pugh B or C, past history of ascites, hepatocellular carcinoma, and oesophageal bleeding were 27.5, 37.5, 49.1, 53.7, and 62.7 kPa, respectively. CONCLUSION: Transient elastography is a promising non-invasive method for detection of cirrhosis in patients with chronic liver disease. Its use for the follow up and management of these patients could be of great interest and should be evaluated further.
Authors: C Aubé; F Oberti; N Korali; M A Namour; D Loisel; J Y Tanguy; E Valsesia; C Pilette; M C Rousselet; P Bedossa; H Rifflet; M Y Maïga; D Penneau-Fontbonne; C Caron; P Calès Journal: J Hepatol Date: 1999-03 Impact factor: 25.083
Authors: C Niederau; S Lange; T Heintges; A Erhardt; M Buschkamp; D Hürter; M Nawrocki; L Kruska; F Hensel; W Petry; D Häussinger Journal: Hepatology Date: 1998-12 Impact factor: 17.425
Authors: Gregory D Kirk; Jacquie Astemborski; Shruti H Mehta; Chuck Spoler; Cedric Fisher; Danisha Allen; Yvonne Higgins; Richard D Moore; Nezem Afdhal; Michael Torbenson; Mark Sulkowski; David L Thomas Journal: Clin Infect Dis Date: 2009-04-01 Impact factor: 9.079
Authors: Perry J Pickhardt; Peter M Graffy; Adnan Said; Daniel Jones; Brandon Welsh; Ryan Zea; Meghan G Lubner Journal: AJR Am J Roentgenol Date: 2019-01-15 Impact factor: 3.959
Authors: Giovanna Ferraioli; Carmine Tinelli; Barbara Dal Bello; Mabel Zicchetti; Raffaella Lissandrin; Gaetano Filice; Carlo Filice; Elisabetta Above; Giorgio Barbarini; Enrico Brunetti; Willy Calderon; Marta Di Gregorio; Roberto Gulminetti; Paolo Lanzarini; Serena Ludovisi; Laura Maiocchi; Antonello Malfitano; Giuseppe Michelone; Lorenzo Minoli; Mario Mondelli; Stefano Novati; Savino F A Patruno; Alessandro Perretti; Gianluigi Poma; Paolo Sacchi; Domenico Zanaboni; Marco Zaramella Journal: World J Gastroenterol Date: 2013-01-07 Impact factor: 5.742