Mansu Choi1, Heejin Kwon2, Jinhan Cho1, Jongyoung Oh1, Kyungjin Nam1, Myungjin Kang1, Eunju Kang1, Sangyeong Han3, Sungwook Lee3. 1. Department of Radiology, Dong-A University Hospital, Dongdaesindong 3ga, Seo-gu, Pusan, 602-715, South Korea. 2. Department of Radiology, Dong-A University Hospital, Dongdaesindong 3ga, Seo-gu, Pusan, 602-715, South Korea. risual@dau.ac.kr. 3. Department of Internal Medicine, Dong-A University Hospital, Dongdaesingdong 3ga, Seo-gu, Pusan, 602-715, South Korea.
Abstract
PURPOSE: In patients with chronic diffuse liver diseases, liver fibrosis severity is an important element for prognosis and for selecting therapy. Acoustic radiation force impulse (ARFI) imaging techniques were recently developed to measure liver fibrosis, but their specificity is impaired by cholestasis, inflammation, or edema in acute hepatitis. Herein, our objectives were to evaluate serial changes in shear wave velocity (SWV) and to correlate these changes with biochemical activity. METHODS: This study included 108 patients who underwent ARFI because of viral hepatitis [hepatitis B (HBV) or C (HCV)] with serial follow-up after 3-6 months at our institution between August 2011 and May 2013. Based on baseline and follow-up ARFI, we divided patients with HBV and HCV into two groups: a decreasing SWV group and a non-decreasing SWV group. We evaluated serial SWV changes and correlated these changes with biochemical activity changes. RESULTS: The patients were divided into SWV groups as follows: decreasing SWV group (HBV, n = 23; HCV, n = 7) and non-decreasing SWV group (HBV, n = 40; HCV, n = 38). In both HBV and HVC patients, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were significantly decreased at follow-up in the decreasing SWV group. CONCLUSIONS: The liver stiffness value assessed by ARFI became lower over time in patients who had decreasing AST and ALT levels. According to this study, ARFI overestimates fibrosis grade in patients with high AST and ALT. Thus, assessment of liver fibrosis by ARFI elastography should include consideration of biochemical markers such as AST and ALT levels and additional follow-up using ARFI elastography.
PURPOSE: In patients with chronic diffuse liver diseases, liver fibrosis severity is an important element for prognosis and for selecting therapy. Acoustic radiation force impulse (ARFI) imaging techniques were recently developed to measure liver fibrosis, but their specificity is impaired by cholestasis, inflammation, or edema in acute hepatitis. Herein, our objectives were to evaluate serial changes in shear wave velocity (SWV) and to correlate these changes with biochemical activity. METHODS: This study included 108 patients who underwent ARFI because of viral hepatitis [hepatitis B (HBV) or C (HCV)] with serial follow-up after 3-6 months at our institution between August 2011 and May 2013. Based on baseline and follow-up ARFI, we divided patients with HBV and HCV into two groups: a decreasing SWV group and a non-decreasing SWV group. We evaluated serial SWV changes and correlated these changes with biochemical activity changes. RESULTS: The patients were divided into SWV groups as follows: decreasing SWV group (HBV, n = 23; HCV, n = 7) and non-decreasing SWV group (HBV, n = 40; HCV, n = 38). In both HBV and HVC patients, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were significantly decreased at follow-up in the decreasing SWV group. CONCLUSIONS: The liver stiffness value assessed by ARFI became lower over time in patients who had decreasing AST and ALT levels. According to this study, ARFI overestimates fibrosis grade in patients with high AST and ALT. Thus, assessment of liver fibrosis by ARFI elastography should include consideration of biochemical markers such as AST and ALT levels and additional follow-up using ARFI elastography.
Authors: I Grgurevic; I Cikara; J Horvat; I K Lukic; R Heinzl; M Banic; M Kujundzic; B Brkljacic Journal: Ultraschall Med Date: 2010-11-23 Impact factor: 6.548
Authors: Mireen Friedrich-Rust; Katrin Wunder; Susanne Kriener; Fariba Sotoudeh; Swantje Richter; Joerg Bojunga; Eva Herrmann; Thierry Poynard; Christoph F Dietrich; Johannes Vermehren; Stefan Zeuzem; Christoph Sarrazin Journal: Radiology Date: 2009-08 Impact factor: 11.105