[The usefulness of transient elastography to diagnose cirrhosis in patients with alcoholic liver disease].
OBJECTIVE
It is not easy to differentiate between patients with cirrhosis and those with alcoholic liver disease. Liver biopsy is generally considered the gold standard for assessing hepatic fibrosis; however, this protocol frequently carries a risk of severe complications and false-negative results. Transient elastography (Fibroscan, Echosens, Paris, France), which is a noninvasive method of measuring liver stiffness, has become available for assessing liver fibrosis. Liver stiffness reportedly differs markedly with the cirrhosis etiology. The aim of this study was thus to determine the diagnostic accuracy of the Fibroscan in the detection of cirrhosis in patients with alcoholic liver disease.


METHODS
We enrolled 45 patients with alcoholic liver disease. Fibroscan, abdominal ultrasonography, aspartate aminotransferase/platelet ratio index (APRI), and liver biopsy were performed on all patients. Fibrosis stage was assessed using the Batts-Ludwig scoring system.


RESULTS
The stage of fibrosis (F1-F4) was distributed among the cohort as follows: 5 patients at F1, 4 patients at F2, 7 patients at F3, and 29 patients at F4. Liver stiffness differed significantly between each fibrosis stage (P<0.001). For the diagnosis of cirrhosis, the area under the receiver operating characteristic curve was 0.97 for transient elastography (95% confidence interval, CI, 0.93-1.01), 0.81 for ultrasonography (95% CI, 0.68-0.94), and 0.83 for APRI score (95% CI, 0.70-0.95). The optimal cut-off value of liver stiffness for detecting cirrhosis was 25.8 kPa, with a sensitivity of 90% and a specificity of 87%.


CONCLUSIONS
Transient elastography is a useful method for diagnosing cirrhosis in patients with alcoholic liver disease.
Institute for Digestive Research, Department of Internal Medicine, SoonChunHyang University College of Medicine, Bucheon, Korea.
Sang Gyune
SG
Kim
Young Seok
YS
Kim
Seung Won
SW
Jung
Hee Kyung
HK
Kim
Jae Young
JY
Jang
Jong Ho
JH
Moon
Hong Soo
HS
Kim
Joon Seong
JS
Lee
Moon Sung
MS
Lee
Chan Sup
CS
Shim
Boo Sung
BS
Kim
D000328:Adult; D001219:Aspartate Aminotransferases / Q000097:blood; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005355:Fibrosis; D006519:Hepatitis, Alcoholic / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012372:ROC Curve
D001219:Aspartate Aminotransferases