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Keywords:
Liver, Abdomen, Ultrasound, Elastography, Diagnostic procedure, Cirrhosis
Authors:
G. Ferraioli, L. Maiocchi, R. Lissandrin, A. De Silvestri, C. Tinelli, C. Filice; Pavia/IT
DOI:
10.1594/ecr2017/B-1248
Results
We studied 411 consecutive patients (218 males and 193 females).
Three hundred and eighty-two patients (92.9%) were affected by chronic hepatitis C.
Patients’ demographics,
their biochemical and stiffness data are reported in Table 1.
Table 1
Characteristics
|
n =411
|
Sex,
men (%)
|
218 (53.0%)
|
Age,
yrs,
(SD)
|
61.2 (13.2)
|
BMI,
kg/m2 (SD)
|
24.6 (3.7)
|
AST,
IU/L (IQR)
|
33 (23-56)
|
ALT,
IU/L (IQR)
|
33 (18-73)
|
ALP,
IU/L (IQR)
|
72 (60-93)
|
GGT,
IU/L (IQR)
|
40 (23-75)
|
Platelets count,
103/mm3,
(SD)
|
168 (74)
|
Fibrosis stage (as assessed with TE)
|
Mild/no fibrosis (F0-F1)
|
179 (43.6%)
|
Significant fibrosis (F2)
|
75 (18.2%)
|
Severe fibrosis (F3)
|
41 (10.0%)
|
Liver cirrhosis (F4)
|
116 (28.2%)
|
SD: standard deviation; IQR: interquartile range; BMI: body mass index; AST: aspartate aminotransferase; ALT: alanine aminotransferase; ALP: alkaline phosphatase; GGT: gamma-glutamyl transferase.
There was a high correlation between SWM and TE (r = 0.76,
p < 0.001)
The optimal cutoff values for staging significant fibrosis (F ≥ 2),
severe fibrosis (F ≥ 3),
and cirrhosis (F = 4) and the performance of the SWM method are reported in Table 2 and Figures 2,
3 and 4.
Table 2
|
F ≥ 2
(95% CI)
|
F ≥ 3
(95% CI)
|
F = 4
(95% CI)
|
Cutoff,
kPa
|
6.44
|
7.82
|
8.40
|
AUROC
|
0.92
(0.89-0.94)
|
0.92
(0.88-0.94)
|
0.94
(0.91-0.96)
|
Sensitivity,
%
|
83.3
(77.4-88.2)
|
86.0
(78.8-91.5)
|
92.3
(84.8-96.9)
|
Specificity,
%
|
87.4
(81.4-92.0)
|
82.6
(77.2-87.2)
|
82.1
(77.1-86.5)
|
PPV,
%
|
88.7
(83.3-92.9)
|
73.0
(65.2-79.9)
|
63.2
(54.4-71.4)
|
NPV,
%
|
81.6
(75.1-87.0)
|
91.5
(87.0-94.9)
|
97.0
(93.9-98.8)
|
LR+
|
6.63
(4.4-9.9)
|
4.95
(3.7-6.6)
|
5.16
(4.0-6.7)
|
LR-
|
0.19
(0.1-0.3)
|
0.17
(0.1-0.3)
|
0.09
(0.05-0.2)
|
CI: confidence interval; PPV: positive predictive value; NPV: negative predictive value; LR+: positive likelihood ratio; LR-: negative likelihood ratio.