Dynamic evaluation of liver stiffness measurement to improve diagnostic accuracy of liver cirrhosis in patients with chronic hepatitis B acute exacerbation.
To investigate the dynamic changes of liver stiffness measurement (LSM) by FibroScan(®) and improve its diagnostic accuracy, we studied patients with chronic hepatitis B undergoing acute exacerbation. Eighty-nine treatment naïve patients were enrolled, and Fibroscan(®) was performed every 7-10 days during hospitalization and every 1∼3 months for follow-up. Haematology and liver functions were tested in parallel. Liver biopsies were performed in 23 patients. A total of 282 LSMs were performed. LSM was positively correlated with both alanine aminotransferase (ALT) (r = 0.321, P < 0.001) and bilirubin levels (r = 0.626, P < 0.001). Mean reduction in LSMs in patients along with ALT or bilirubin normalization was significantly greater than those without ALT or bilirubin normalization(P = 0.001, P = 0.038, respectively). In 23 patients with initial LSMs in the range usually defined as indicating cirrhosis (i.e.>18.2 kPa), only 5 were diagnosed with cirrhosis by histopathology or ultrasonography. As ALT normalized, LSMs remained over 12.0 kPa in all these 5 patients. However, in 18 other patients without cirrhosis at baseline, LSMs still remained above 12.0kPa in 10 patients and decreased to below 12.0 kPa in the other 8 patients. LSMs decreased in parallel with ALT and bilirubin normalization. LSM performed after ALT and bilirubin normalization may improve the accuracy in diagnosing cirrhosis in patients with exacerbations of hepatitis B.
Hepatology Unit and Department of Infectious Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China.
X-E
XE
Liang
Y-P
YP
Chen
Q
Q
Zhang
L
L
Dai
Y-F
YF
Zhu
J-L
JL
Hou
D000328:Adult; D001706:Biopsy; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D006651:Histocytochemistry; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged