Korean J Hepatol.  2010 Jun;16(2):123-130. 10.3350/kjhep.2010.16.2.123.

Clinical factors influencing liver stiffness as measured by transient elastography (Fibroscan(R)) in patients with chronic liver disease

• Bae RC
• Cho HJ
• Oh JT
• Lee EK
• Heo J
• Shin KY
• Park SY
• Jeong MK
• Jeon SW
• Cho CM
• Tak WY
• Kweon YO

• KMID: 1792590
• DOI: http://doi.org/10.3350/kjhep.2010.16.2.123

Abstract

BACKGROUND/AIMS
Transient elastography as performed using the Fibroscan(R) is a useful noninvasive method for evaluating hepatic fibrosis. However, recent studies have found that liver stiffness measurement (LSM) values are inappropriately elevated in acute hepatitis or in the acute flare state of chronic hepatitis, suggesting that the LSM value obtained by the Fibroscan(R) is not a reliable marker for fibrosis. We retrospectively evaluated the clinical factors influencing the LSM value obtained using transient elastography as performed using the Fibroscan(R) in patients with chronic liver disease.
METHODS
A total of 298 patients who were followed in Kungpook National University Hospital from November 2007 to May 2008 due to previously established liver cirrhosis or chronic liver disease were investigated using the Fibroscan(R), laboratory test, ultrasound, and/or abdominal computed tomography.
RESULTS
The 298 patients were aged 47.8+/-12.9 years (mean+/-SD). The cut-off value for a diagnosis of liver cirrhosis was 12.5 kPa (as used in previous studies). Thirty-six patients (15%) and 202 patients (85%) with chronic liver disease without clinical manifestation of cirrhosis had LSMs of >12.5 kPa and <12.5 kPa, respectively. Multivariate analysis revealed that LSM values were unusually increased in patients with chronic liver disease who were older (P=0.007) or who had increased gamma gultamyltranspetidase (GGT) (P=0.022), decreased albumin (P=0.015), or increased total bilirubin (P=0.009).
CONCLUSIONS
This study reveals that age, GGT, and albumin are clinical factors influencing LSM values. This reinforces the need to interpret LSM values in the context of a defined diagnosis, biochemical data, radiologic examination, and other clinical findings.

Keyword

Transient elastography; Liver stiffness measurement; Chronic liver disease

MeSH Terms

Adult
Age Factors
Bilirubin/metabolism
Biological Markers/blood
Chronic Disease
*Elasticity Imaging Techniques
Female
Hepatitis/diagnosis/ultrasonography
Humans
Liver Cirrhosis/diagnosis/ultrasonography
Liver Diseases/diagnosis/radiography/*ultrasonography
Male
Middle Aged
Retrospective Studies
Serum Albumin/metabolism
Tomography, X-Ray Computed
gamma-Glutamyltransferase/metabolism