Transient elastography: a valid alternative to biopsy in patients with chronic liver disease.
BACKGROUND
Transient elastography is a novel and non-invasive technique for the evaluation of fibrosis in chronic liver disease. Few studies that exist value the efficacy of transient elastography, mainly in hepatitis C virus-infected patients.


OBJECTIVE
To evaluate the effectiveness, objectivity, reproducibility and safety of this technique.


METHODS
We included 103 consecutive patients who underwent a liver biopsy in the last 48 months with a wide spectrum of chronic liver diseases. Median stiffness value (expressed as kilopascals - kPa) was kept as representative of the liver elastic modulus. All biopsy specimens were analysed by the same pathologist according to the METAVIR scoring system.


RESULTS
Median value of stiffness in patients with mild or moderate fibrosis (FI and FII), and severe fibrosis or cirrhosis (FIII and FIV) was of 7, 4 +/- 5 and 16, 4 +/- 10 kPa, respectively, with a significant difference between them (P < 0.05). The areas under the receiver operating characteristic curves showed the optimal liver stiffness cut-off values for each group.


CONCLUSIONS
We found a positive correlation between the liver stiffness found by transient elastography and fibrosis stage on biopsy in all patients, independently of the liver disease aetiology. Transient elastography is an easy, quick to perform and safe non-invasive procedure, reliable for assessing liver fibrosis.
Gómez-Domínguez
E
E
Gastroenterology and Hepatology Service, Hospital Universitário de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain.
Mendoza
J
J
Rubio
S
S
Moreno-Monteagudo
J A
JA
García-Buey
L
L
Moreno-Otero
R
R
D001706:Biopsy / Q000379:methods / Q000592:standards; D002908:Chronic Disease; D004548:Elasticity; D005260:Female; D019698:Hepatitis C, Chronic / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity