Effects of patient factors on noninvasive liver stiffness measurement using acoustic radiation force impulse elastography in patients with chronic hepatitis C

BMC Gastroenterology

Research Article

Wen-Pang Su¹  Jung-Ta Kao¹  Po-Heng Chuang¹  Sheng-Hung Chen¹  Hsueh-Chou Lai²  Cheng-Yuan Peng³  Yu-Fen Li⁴  I-Ping Chiang⁵ 

[1] Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, No 2 Yuh-Der Road, 40402, Taichung, Taiwan;China Medical University, 40402, Taichung, Taiwan;Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, No 2 Yuh-Der Road, 40402, Taichung, Taiwan;College of Chinese Medicine, China Medical University, 40402, Taichung, Taiwan;Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, No 2 Yuh-Der Road, 40402, Taichung, Taiwan;School of Medicine, China Medical University, 40402, Taichung, Taiwan;Institute of Biostatistics Center, China Medical University, 40402, Taichung, Taiwan;School of Medicine, China Medical University, 40402, Taichung, Taiwan;Department of Pathology, China Medical University Hospital, 40402, Taichung, Taiwan;

关键词: Liver fibrosis;    Cirrhosis;    Acoustic radiation force impulse;    FibroTest;    ActiTest;    Chronic hepatitis C;   

DOI  :  10.1186/1471-230X-12-105

 received in 2012-02-24, accepted in 2012-08-02,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundPrevious research has shown variation in the effects of patient factors, including hepatic necroinflammatory activity, on liver stiffness measurement (LSM). This prospective study attempts to identify explanatory factors for LSM in patients with chronic hepatitis C (CHC) using acoustic radiation force impulse (ARFI) technology.MethodsA cohort of 127 Taiwanese patients with CHC underwent ARFI LSM and immediate percutaneous liver biopsy. This study compares the concurrent diagnostic performances of LSM and FibroTest using receiver operating characteristic (ROC) curves. Three multiple linear regression models were used to evaluate the significance of concurrent patient factors in explaining LSM.ResultsTo classify METAVIR fibrosis (F) stages, the areas under ROC curves (AUCs) were ARFI LSM, 0.847 (95% confidence interval (CI), 0.779-0.914) and FibroTest, 0.823 (95% CI, 0.748-0.898), for F1 versus F2-4; ARFI LSM, 0.902 (95% CI, 0.835-0.970) and FibroTest, 0.812 (95% CI, 0.735-0.888), for F1-2 versus F3-4; ARFI LSM, 0.831 (95% CI, 0.723-0.939) and FibroTest, 0.757 (95% CI, 0.648-0.865), for F1-3 versus F4. After adjusting for other demographic and biological covariates, biochemical and histological necroinflammatory factors consistently explained LSM. Factors included serum alanine aminotransferase (ALT)/upper limit of normal (ULN) categories (model R2 = 0.661, adjusted R2 = 0.629), ActiTest A scores (R2 = 0.662, adjusted R2 = 0.636), and METAVIR activity (A) grades (R2 = 0.651, adjusted R2 = 0.620). METAVIR F stages, body mass index, and platelet count were also independently associated with LSM. Necroinflammatory degrees, including ALT/ULN, ActiTest A scores, and METAVIR A grades, explained the false positivity of liver fibrosis staging using ARFI LSM.ConclusionsThe degree of hepatic necroinflammatory activity independently and significantly exaggerated liver fibrosis evaluation using ARFI LSM. However, comparisons with concurrent FibroTest indicate that ARFI LSM may be a promising alternative, or adjunctive single indicator, for liver fibrosis evaluation in patients with CHC.

【 授权许可】

Unknown   
© Chen et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.