title: FibroScan and ultrasonography in the prediction of hepatic fibrosis in patients with chronic viral hepatitis.
abstract: BACKGROUND
  The aim of this study was to assess the diagnostic performances of liver stiffness measurement (LSM), ultrasonography (US) and their combined use in predicting the extent of hepatic fibrosis.
  
  
  METHODS
  Consecutive patients with chronic hepatitis B (HBV) or hepatitis C virus (HCV) infections, with indications for liver biopsy, were prospectively enrolled. LSM was performed on the same day as biopsy. US scores, including assessment of liver surface, liver parenchyma, intrahepatic vessels and spleen index, were used to assess the degree of hepatic fibrosis. The pathological findings were used as a reference standard and diagnostic accuracy was assessed and compared.
  
  
  RESULTS
  Three-hundred and twenty patients, including 199 men and 121 women, with a mean age of 50.8 years, were analyzed. There were 214 (66.9%) HCV patients, 88 (27.5%) HBV patients and 18 (5.6%) patients with both HCV and HBV. LSM correlated significantly with the hepatic fibrosis (F) scores, necro-inflammatory activity and US scores in multivariate analysis. The diagnostic accuracy of LSM is significantly superior to US, and equal to combined LSM with US, in the prediction of all HCV-related fibrosis scores. The cut-off value of LSM is 6 kPa for diagnosing F > =1, with a positive predictive value of 91%. Also, the cut-off value is 12 kPa for the prediction of cirrhosis, with a negative predictive value of 94%.
  
  
  CONCLUSIONS
  LSM is useful for predicting hepatic fibrosis and excluding cirrhosis. A combination of LSM and US does not improve the accuracy in assessing hepatic fibrosis.
authors.affiliation: Department of Internal Medicine, Division of Hepato-Gastroenterology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Niao Sung, Kaohsiung, Taiwan.
authors.forename: Jing-Houng
authors.initials: JH
authors.lastname: Wang
authors.forename: Chi-Sin
authors.initials: CS
authors.lastname: Changchien
authors.forename: Chao-Hung
authors.initials: CH
authors.lastname: Hung
authors.forename: Hock-Liew
authors.initials: HL
authors.lastname: Eng
authors.forename: Wei-Chih
authors.initials: WC
authors.lastname: Tung
authors.forename: Kwong-Ming
authors.initials: KM
authors.lastname: Kee
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Chen
authors.forename: Tsung-Hui
authors.initials: TH
authors.lastname: Hu
authors.forename: Chuan-Mo
authors.initials: CM
authors.lastname: Lee
authors.forename: Sheng-Nan
authors.initials: SN
authors.lastname: Lu
mesh_terms: D001707:Biopsy, Needle; D054459:Elasticity Imaging Techniques; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests