Diagnostic value of real-time tissue elastography for liver fibrosis in patients with chronic hepatitis B

Objective To investigate the diagnostic value of real- time tissue elastography (RTE) in evaluating liver fibrosis in patients with chronic hepatitis B (CHB) . Methods Eighty- six patients with CHB, who visited Beijing Tiantan Hospital and Beijing You'an Hospital from March to August, 2013, were grouped according to the pathological stages of liver fibrosis. They were examined by RTE, biochemical tests, and liver biopsy. Then, liver fibrosis index ( LFI) and aspartate aminotransferase- to- platelet ratio index ( APRI) were calculated. Comparison between groups was made by one- way analysis of variance, followed by LSD t- test for multiple comparisons. The correlation between LFI and pathological stage of liver fibrosis was analyzed by Spearman correlation test. The sensitivity and specificity of LFI for the diagnosis of liver fibrosis were calculated. Regarding S≥2 (significant liver fibrosis) and S≥4 (early liver cirrhosis) as the positive standards, the receiver operating characteristic (ROC) curve was drawn and compared with APRI. Results LFI differed significantly across the groups (P = 0. 000) , except the comparison between S0 and S1 (P = 0. 298) . LFI was significantly correlated with pathological stage (r = 0. 831, P < 0. 001) . The areas under the ROC curve of LFI in diagnosing significant liver fibrosis and early liver cirrhosis were0. 873 (P < 0. 001) and 0. 923 (P = 0. 002) , respectively; the diagnostic thresholds were 2. 74 and 3. 61, respectively; the sensitivity and specificity were 0. 766 /0. 872 and 0. 833 /0. 878, respectively. LFI was significantly superior to APRI. Conclusion RTE has high diagnostic values for significant liver fibrosis and early liver cirrhosis and is an important noninvasive diagnostic method for liver fibrosis in patients with CHB.