title: Shear wave velocity is a useful marker for managing nonalcoholic steatohepatitis.
abstract: OBJECTIVE
  To investigate whether a noninvasive measurement of tissue strain has a potential usefulness for management of nonalcoholic steatohepatitis (NASH).
  
  
  METHODS
  In total 26 patients, 23 NASHs and 3 normal controls were enrolled in this study. NASH was staged based on Brunt criterion. At a region of interest (ROI), a shear wave was evoked by implementing an acoustic radiation force impulse (ARFI), and the propagation velocity was quantified.
  
  
  RESULTS
  Shear wave velocity (SWV) could be reproducibly quantified at all ROIs in all subjects except for 4 NASH cases, in which a reliable SWV value was not calculated at several ROIs. An average SWV of 1.34 +/- 0.26 m/s in fibrous stage 0-1 was significantly slower than 2.20 +/- 0.74 m/s and 2.90 +/- 1.01 m/s in stages 3 and 4, respectively, but was not significantly different from 1.79 +/- 0.78 m/s in stage 2. When a cutoff value was set at 1.47 m/s, receiver operating characteristic analysis showed significance to dissociate stages 3 and 4 from stage 0-1 (P = 0.0092) with sensitivity, specificity and area under curve of 100%, 75% and 94.2%, respectively. In addition, the correlation between SWV and hyaluronic acid was significant (P < 0.0001), while a tendency toward negative correlation was observed with serum albumin (P = 0.053).
  
  
  CONCLUSIONS
  The clinical implementation of ARFI provides noninvasive repeated evaluations of liver stiffness at an arbitrary position, which has the potential to shed new light on NASH management.
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata 951-8122, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Osaki
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kubota
authors.forename: Takeshi
authors.initials: T
authors.lastname: Suda
authors.forename: Masato
authors.initials: M
authors.lastname: Igarashi
authors.forename: Keisuke
authors.initials: K
authors.lastname: Nagasaki
authors.forename: Atsunori
authors.initials: A
authors.lastname: Tsuchiya
authors.forename: Masahiko
authors.initials: M
authors.lastname: Yano
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Tamura
authors.forename: Masaaki
authors.initials: M
authors.lastname: Takamura
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kawai
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamagiwa
authors.forename: Toru
authors.initials: T
authors.lastname: Kikuchi
authors.forename: Minoru
authors.initials: M
authors.lastname: Nomoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Aoyagi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005234:Fatty Liver / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D008099:Liver / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012709:Serum Albumin / Q000378:metabolism; D055815:Young Adult
chemical_list: D015415:Biomarkers; D012709:Serum Albumin; D006820:Hyaluronic Acid