ISSN: 2564-8896
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ABSTRACT

Assessment of Liver Fibrosis Using Real-time Shear-wave Elastography for Patients with Hepatitis B e Antigen-negative Chronic Hepatitis B and Alanine Transaminase <2 Times the Upper Limit of Normal

VOLUME 69 - NUMBER 5 / September - October (Original Article)  doi: 10.24875/RIC.17002215

Jing-Hua Liu, Departments of Gastroenterology and Hepatology, the 4th Affiliated Hospital of Kunming Medical University, Kunming, China
Yu Zou, Departments of Gastroenterology and Hepatology, the 4th Affiliated Hospital of Kunming Medical University, Kunming, China
Wei Chang, Departments of Biostatistics, Kunming Medical University; the 4th Affiliated Hospital of Kunming Medical University, Kunming, China
Jun Wu, Departments of Neurosurgery, Kunming City First People´s Hospital; the 4th Affiliated Hospital of Kunming Medical University, Kunming, China
Yu-Chen Xie, Departments of Pathology, the 4th Affiliated Hospital of Kunming Medical University, Kunming, China
Yong-Ping Lu, Diagnostic Imaging, the 4th Affiliated Hospital of Kunming Medical University, Kunming, China
Jia Wei, Departments of Gastroenterology and Hepatology, the 4th Affiliated Hospital of Kunming Medical University, the 4th Affiliated Hospital of Kunming Medical University, Kunming, China

Background: We assessed liver fibrosis using real-time shear-wave elastography (SWE) combined with liver biopsy (LB) for patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) and alanine transaminase < 2 times the upper limit of normal and hepatitis B virus DNA < 2000 IU/ml. Methods: A total of 107 patients met the inclusion criteria. Real-time SWE and ultrasoundassisted liver biopsies were consecutively performed. Fibrosis was staged according to the METAVIR scoring system. Analyses of receiver operating characteristic curve were performed to calculate the optimal area under the receiver operating characteristic curve for F0-F1 versus F2-F4, F0-F2 versus F3-F4, and F0-F3 versus F4 for real-time SWE. Results: The most concurrent liver fibrosis degrees were between F1 and F2 for these HBeAg-negative CHB patients. Liver stiffness increased in parallel with the degree of liver fibrosis using SWE measurements. The area under the receiver operating characteristic curves was 0.881 (95% confidence interval [CI]: 0.704-1.000) for SWE (p = 0.004); 0.912 (95% CI: 0.836-0.987) for SWE (p = 0.000); 0.981 (95% CI: 0.956-1.000) for SWE (p = 0.000); 0.974 (95% CI: 0.936-1.000) for SWE (p = 0.000) when comparing F0 versus F1-F4, F0-F1 versus F2-F4, F0-F2 versus F3-F4, and F0-F3 versus F4, respectively. Conclusions: SWE has the advantage of providing an image of liver stiffness in real-time. As an alternative to LB, the development of all these noninvasive methods for dynamic evaluation of liver fibrosis will decrease the need for LB, making clinical care safer and more convenient for patients with liver diseases.

Keywords: Alanine transaminase. Chronic hepatitis B. Elastography. Liver biopsy. Liver fibrosis. Ultrasound.

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