Liver stiffness measurement by transient elastography in clinical practice.
The AIM of our study was to evaluate the results of transient elastography assessment of liver stiffness (LS) in various categories of patients.


METHODS
We performed transient elastography in 986 patients. We evaluated: the percentage of cases in which valid measurements could be obtained; the values of LS in 40 patients with no history of chronic liver disease ("normal" patients); 44 inactive HBsAg carriers; 173 patients with proven liver cirrhosis; and the correlation between liver biopsy results and LS in 93 patients with chronic HCV hepatitis.


RESULTS
We obtained valid measurements of LS in 94.6% of the 986 cases. Male gender, younger age and low BMI were positive predictive factors for obtaining valid measurements. The mean values of LS were: 5.2+/-1.3 kPa in "normal" patients, 5.8+/-2.6 kPa in inactive HBsAg carriers, 37.2+/-20.9 kPa in patients with liver cirrhosis. In patients with chronic HCV hepatitis, we found that the mean value of LS in those with METAVIR F>=2 was 8.5+/-4.2 kPa, higher than in those with F<2: 5.3+/-1.4 kPa (p=0.0017). In patients with F>=3, the mean value of LS was 11.1+/-4.3 kPa, significantly higher than in patients with F<3: 6.1+/-2.5 kPa (p<0.0001).


CONCLUSIONS
Liver stiffness, as a marker of fibrosis, can be evaluated by means of transient elastography in a great majority of patients. It is a useful method for the exclusion of significant liver fibrosis and for predicting liver cirrhosis. As compared to liver biopsy, transient elastography can discern significant fibrosis from no or mild fibrosis.
Sporea
Ioan
I
Department of Gastroenterology and Hepatology, Timisoara 13 Snagov Str., Timisoara, Romania. isporea@excite.com
Sirli
Roxana
R
Deleanu
Alexandra
A
Popescu
Alina
A
Cornianu
Marioara
M
D000328:Adult; D000367:Age Factors; D001706:Biopsy; D015992:Body Mass Index; D002353:Carrier State / Q000175:diagnosis / Q000473:pathology / Q000821:virology; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D019698:Hepatitis C, Chronic / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012737:Sex Factors