Gut Liver.  2016 Mar;10(2):275-282. 10.5009/gnl14391.

Factors Influencing the Diagnostic Accuracy of Acoustic Radiation Force Impulse Elastography in Patients with Chronic Hepatitis B

Affiliations
  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ksukorea@yuhs.ac
  • 2Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Korea.
  • 3Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
  • 4Liver Cirrhosis Clinical Research Center, Seoul, Korea.
  • 5Department of Gastroenterology and Hepatology, Kyungpook National University, Daegu, Korea.
  • 6Brain Korea 21 Project for Medical Science, Seoul, Korea.

Abstract

BACKGROUND
/AIMS
To determine factors predictive of discordance in staging liver fibrosis using liver biopsy (LB) and acoustic radiation force impulse (ARFI) elastography in patients with chronic hepatitis B (CHB).
METHODS
Consecutive patients with CHB who underwent LB and ARFI elastography on the same day from November 2010 to March 2013 were prospectively recruited from three tertiary hospitals.
RESULTS
We analyzed 105 patients (median age of 47 years). The F0-1, F2, F3, and F4 fibrosis stages were identified in 27 (25.7%), 27 (25.7%), 21 (20.0%), and 30 (28.6%) patients, respectively. The areas under the receiver operating characteristics curves for ARFI elastography in assessing ≥F2, ≥F3, and F4 was 0.814, 0.848, and 0.752, respectively. The discordance of at least one stage between LB and ARFI was observed in 68 patients (64.8%) and of at least two stages in 16 patients (15.2%). In a multivariate analysis, advanced fibrosis stage (F3-4) was the only factor that was negatively correlated with one-stage discordance (p=0.042). Moreover, advanced fibrosis stage was negatively (p=0.016) correlated and body mass index (BMI) was positively (p=0.006) correlated with two-stage discordance.
CONCLUSIONS
Advanced fibrosis stage (F3-4) was a predictor of nondiscordance between LB and ARFI elastography; BMI also influenced the accuracy of ARFI elastography.

Keyword

Acoustic radiation force impulse; Discordance; Liver cirrhosis; Hepatitis B; chronic
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