Shear wave velocity is a useful marker for managing nonalcoholic steatohepatitis.
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.
Osaki
Akihiko
A
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.
Kubota
Tomoyuki
T
Suda
Takeshi
T
Igarashi
Masato
M
Nagasaki
Keisuke
K
Tsuchiya
Atsunori
A
Yano
Masahiko
M
Tamura
Yasushi
Y
Takamura
Masaaki
M
Kawai
Hirokazu
H
Yamagiwa
Satoshi
S
Kikuchi
Toru
T
Nomoto
Minoru
M
Aoyagi
Yutaka
Y
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
D015415:Biomarkers; D012709:Serum Albumin; D006820:Hyaluronic Acid