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FibroScan and ultrasonography in the prediction of hepatic fibrosis in patients with chronic viral hepatitis

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

The aim of this study was to assess the diagnostic performances of liver stiffness measurement (LSM), ultrasonography (US) and their combined use in predicting the extent of hepatic fibrosis.

Methods

Consecutive patients with chronic hepatitis B (HBV) or hepatitis C virus (HCV) infections, with indications for liver biopsy, were prospectively enrolled. LSM was performed on the same day as biopsy. US scores, including assessment of liver surface, liver parenchyma, intrahepatic vessels and spleen index, were used to assess the degree of hepatic fibrosis. The pathological findings were used as a reference standard and diagnostic accuracy was assessed and compared.

Results

Three-hundred and twenty patients, including 199 men and 121 women, with a mean age of 50.8 years, were analyzed. There were 214 (66.9%) HCV patients, 88 (27.5%) HBV patients and 18 (5.6%) patients with both HCV and HBV. LSM correlated significantly with the hepatic fibrosis (F) scores, necro-inflammatory activity and US scores in multivariate analysis. The diagnostic accuracy of LSM is significantly superior to US, and equal to combined LSM with US, in the prediction of all HCV-related fibrosis scores. The cut-off value of LSM is 6 kPa for diagnosing F > =1, with a positive predictive value of 91%. Also, the cut-off value is 12 kPa for the prediction of cirrhosis, with a negative predictive value of 94%.

Conclusions

LSM is useful for predicting hepatic fibrosis and excluding cirrhosis. A combination of LSM and US does not improve the accuracy in assessing hepatic fibrosis.

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Acknowledgment

This study was supported by a grant from Chang Gung Memorial Hospital (CMRP G850141) to Sheng-Nan Lu.

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Authors and Affiliations

  1. Division of Hepato-Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, 123, Ta Pei Road, Niao Sung 833, Kaohsiung, Taiwan

    Jing-Houng Wang, Chi-Sin Changchien, Chao-Hung Hung, Wei-Chih Tung, Kwong-Ming Kee, Chien-Hung Chen, Tsung-Hui Hu, Chuan-Mo Lee & Sheng-Nan Lu

  2. Department of Pathology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Hock-Liew Eng

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  1. Jing-Houng Wang
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  2. Chi-Sin Changchien
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Correspondence to Sheng-Nan Lu.

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Wang, JH., Changchien, CS., Hung, CH. et al. FibroScan and ultrasonography in the prediction of hepatic fibrosis in patients with chronic viral hepatitis. J Gastroenterol 44, 439–446 (2009). https://doi.org/10.1007/s00535-009-0017-y

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  • DOI: https://doi.org/10.1007/s00535-009-0017-y

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