title: The usefulness of measuring liver stiffness by transient elastography for assessing hepatic fibrosis in patients with various chronic liver diseases.
abstract: OBJECTIVE
  The degree of hepatic fibrosis is an important factor for prognosis and management of patients with chronic liver disease; however, liver biopsy is an invasive method of measuring fibrosis. Here, we investigated the diagnostic utility of liver stiffness, as measured by transient elastography in assessing hepatic fibrosis of viral chronic liver disease and nonalcoholic fatty liver disease (NAFLD).
  
  
  METHODS
  Four hundred and nine eligible patients underwent transient elastography to measure liver stiffness. Liver biopsy for histopathological assessment of fibrosis (F0-F4) was performed in 71 of these patients. Serum levels of hyaluronic acid were determined in 110 patients. We assessed liver stiffness in several chronic liver diseases and compared correlations among liver stiffness, hepatic fibrosis stage and serum hyaluronic acid levels.
  
  
  RESULTS
  A steady stepwise increase in liver stiffness was observed with progressing severity of hepatic fibrosis (p<0.0001) in 71 patients who underwent liver biopsy. In 32 chronic viral hepatitis patients, measuring liver stiffness was useful for differentiating between F1, or F2, or F3 and F4, while in 32 NAFLD liver stiffness can differentiate between F0 and F1, F2, or F3, F1 and F3 or F4 and F2 and F4. There was no significant correlation between liver fibrotic stages and serum hyaluronic levels.
  
  
  CONCLUSIONS
  The present data advocates measuring liver stiffness for assessing hepatic fibrosis is more sensitive in NAFLD than viral chronic diseases, and liver stiffness is useful compared to serum hyaluronic acid level in estimating hepatic fibrosis.
authors.affiliation: Department of Gastroenterology, Dokkyo Medical University, Saitama, Japan. mstamano@dokkyomed.ac.jp
authors.forename: Masaya
authors.initials: M
authors.lastname: Tamano
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kojima
authors.forename: Takashi
authors.initials: T
authors.lastname: Akima
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Murohisa
authors.forename: Takashi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Chizu
authors.initials: C
authors.lastname: Uetake
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sugaya
authors.forename: Masakazu
authors.initials: M
authors.lastname: Nakano
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Hiraishi
authors.forename: Masashi
authors.initials: M
authors.lastname: Yoneda
mesh_terms: D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D004548:Elasticity; D054459:Elasticity Imaging Techniques; D005234:Fatty Liver / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D019694:Hepatitis B, Chronic / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D019698:Hepatitis C, Chronic / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D007564:Japan; D008099:Liver / Q000473:pathology* / Q000821:virology; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000821:virology; D065626:Non-alcoholic Fatty Liver Disease; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D006820:Hyaluronic Acid