Diagnosis of liver fibrosis based on quantification of factors associated with shear wave speed

Abstract

Purpose: Liver stiffness (LS) measured using ultrasound shear wave elastography is reported to be influenced not only by liver fibrosis but also by other clinical conditions such as hepatic inflammation, jaundice, and liver congestion. The aim of this study was to investigate the influence of liver fibrosis, hepatic necrosis, and inflammation on LS. Materials and Methods: Of 7,825 chronic liver disease cases, 809 patients who met our study criteria were included. LS measurements obtained using transient elastography (TE) and Virtual Touch Quantification (VTQ) were compared with histologically evaluated liver fibrosis stage and necro-inflammatory activity grade. Results and Discussion: The area under the receiver-operating characteristic curve of TE to predict F2≤, F3≤, and F4 was 0.809, 0.860, and 0.947, respectively, and that of VTQ was 0.793, 0.836, and 0.941, respectively. LS showed significant increase with the progression of fibrosis. In addition, LS showed significant increase with the progression of hepatic necrosis and inflammation. In the analysis based on each fibrosis grade, LS showed an increase along with the severity of inflammation, except in F4 (liver cirrhosis) cases. Conclusions: LS measurement is useful in predicting liver fibrosis stage noninvasively, but it can be influenced by hepatic inflammation. Therefore, LS measurements should be interpreted with caution.