title: [Noninvasive evaluation of liver fibrosis in chronic hepatitis B patients].
abstract: OBJECTIVE
  To investigate the clinical usefulness of noninvasive diagnostic methods in evaluating liver fibrosis in hepatitis B virus (HBV) patients.
  
  
  METHODS
  102 patients with chronic hepatitis B (CHB) were enrolled from Beijing Friendship Hospital Affiliated to Capital University of Medical Sciences. Noninvasive diagnostic methods including ultrasonography, CT, serum markers of liver function and fibrosis, and HBV DNA were performed and compared with histological fibrotic changes in order to establish a noninvasive method for detecting the degree of liver fibrosis.
  
  
  RESULTS
  The total score of liver surface, edge, parenchyma echogenicity, intrahepatic vessels, and the size of spleen had a coefficient of 0.822 with fibrotic stage. By receiver operating curve (ROC) analysis, the sensitivity to distinguish cirrhosis from CHB was 86.1% and the specificity was 95.5% if the total ultrasonic score was more than 10. The CT imaging diagnosed liver cirrhosis with a specificity of 100% and a sensitivity of 48.5%. The change of CT values in cirrhotic patients was lower than that in controls and no cirrhotic patients (F=5.805, P<0.01), when the voltage was increased from 100 KV to 140 KV. Except normal controls and S1 group, S2 and S3 group, the level of HA and collagen IV between the other groups were statistically different. The cut-off value of HA to diagnose cirrhosis was 108 (microg/L) with a sensitivity of 72.2% and a specificity of 80.3%. The cut-off value of collagen IV to diagnose cirrhosis was 188 (microg/L) with a sensitivity of 72.2% and a specificity of 78.8%. When ultrasonography was combined with serum markers, the sensitivity was 72.2% and the specificity was 80.3%.
  
  
  CONCLUSIONS
  Both ultrasonography and serum markers are useful to diagnose cirrhosis. The combination of the two examinations is more valuable than any one alone. The characteristic CT imaging has high specificity but low sensitivity in diagnosing early cirrhosis. HA and collagen IV are correlated more closely with the stage of fibrosis, and can reflect the severity of fibrosis.
authors.affiliation: Center for Artificial Liver, Beijing You'an Hospital, Affiliated to Capital University of Medical Sciences, Beijing 100054, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.forename: Bao-en
authors.initials: BE
authors.lastname: Wang
authors.forename: Ji-dong
authors.initials: JD
authors.lastname: Jia
authors.forename: Lin-xue
authors.initials: LX
authors.lastname: Qian
authors.forename: Tai-ling
authors.initials: TL
authors.lastname: Wang
authors.forename: Min-hua
authors.initials: MH
authors.lastname: Chen
authors.forename: Guang-yong
authors.initials: GY
authors.lastname: Chen
authors.forename: Wen
authors.initials: W
authors.lastname: He
authors.forename: Hui-guo
authors.initials: HG
authors.lastname: Ding
authors.forename: Shan-shan
authors.initials: SS
authors.lastname: Yin
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Zhong
authors.initials: Z
authors.lastname: Dong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D024141:Collagen Type IV / Q000097:blood; D005260:Female; D019694:Hepatitis B, Chronic / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D024141:Collagen Type IV; D006820:Hyaluronic Acid