Variability in liver stiffness values from different intercostal spaces.
OBJECTIVE
To investigate the variability in liver stiffness measurement (LSM) values from the fifth, sixth and seventh intercostal space (ICS) and examine whether LSM better predicts significant fibrosis (F2-4) and cirrhosis when LSM is performed at the same site as liver biopsy (LB).


METHODS
This study enrolled 91 consecutive patients with hepatitis B virus (HBV)-related chronic liver disease (CLD) who underwent both LB and LSM between September 2007 and January 2009.


RESULTS
The mean age of the patients was 45.4 years (66 men and 25 women). F1 fibrosis was noted in 12 patients (13.2%), F2 in 28 (30.7%), F3 in 15 (16.5%) and F4 in 36 (39.6%). The mean LSM values from the fifth, sixth and seventh ICS were 11.6, 11.1 and 10.9 kPa respectively. The mean LSM value from the same site as LB was 11.0 kPa. An interclass correlation analysis showed no significant difference in LSM values from the fifth, sixth and seventh ICS and the same site as LB. The area under the receiver operating characteristic curves of LSM values from the fifth, sixth and seventh ICS and the same site as LB for predicting significant fibrosis were 0.815, 0.838, 0.818 and 0.837, respectively, and those for cirrhosis were 0.919, 0.916, 0.907 and 0.913, respectively, with all overlapping confidence intervals.


CONCLUSIONS
Any LSM value from the fifth, sixth or seventh ICS can predict significant fibrosis and cirrhosis with considerable accuracy without statistical differences regardless of correspondence with LB site in patients with HBV-related CLD.
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Seung Up
SU
Kim
Ja Kyung
JK
Kim
Jun Yong
JY
Park
Sang Hoon
SH
Ahn
Jung Min
JM
Lee
Oidov
O
Baatarkhuu
Eun Hee
EH
Choi
Kwang-Hyub
KH
Han
Chae Yoon
CY
Chon
Do Young
DY
Kim
D000328:Adult; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D007723:Korea; D008099:Liver / Q000000981:diagnostic imaging*; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014463:Ultrasonography