title: Real-time tissue elastography for evaluation of hepatic fibrosis and portal hypertension in nonalcoholic fatty liver diseases.
abstract: The aim of this study was to prospectively measure liver stiffness with real-time tissue elastography in patients with nonalcoholic fatty liver diseases (NAFLD) and to compare the result with the clinical assessment of fibrosis using histological stage. One hundred and eighty-one prospectively enrolled patients underwent real-time tissue elastography, with the first 106 being analyzed as the training set and the remaining 75 being evaluated as the validation set. Hepatic and splenic elastic ratios were calculated and compared with stage of histological fibrosis. Portal hypertension (PH) was assessed. Real-time tissue elastography cut-off values by stage in the training set were 2.47 for F1, 2.67 for F2, 3.02 for F3, and 3.36 for F4. Using these cut-off values, the diagnostic accuracy of hepatic fibrosis in the validation set was 82.6%-96.0% in all stages. Only portal fibrosis correlated with the hepatic elastic ratio by multivariate analysis. The area under the receiver operating characteristic curve of elastic ratio better correlated than serum fibrosis markers in both early and advanced fibrosis stages. Patients with PH, defined by splenic elasticity, had early fibrosis. Patients with severe PH were found only in the group with cirrhosis.
  
  
  CONCLUSIONS
  Real-time tissue elastography is useful in evaluating hepatic fibrosis and PH in patients with NAFLD.
authors.affiliation: Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Ochi
authors.forename: Masashi
authors.initials: M
authors.lastname: Hirooka
authors.forename: Yohei
authors.initials: Y
authors.lastname: Koizumi
authors.forename: Teruki
authors.initials: T
authors.lastname: Miyake
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tokumoto
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Soga
authors.forename: Fujimasa
authors.initials: F
authors.lastname: Tada
authors.forename: Masanori
authors.initials: M
authors.lastname: Abe
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Hiasa
authors.forename: Morikazu
authors.initials: M
authors.lastname: Onji
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001707:Biopsy, Needle; D015331:Cohort Studies; D016001:Confidence Intervals; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005069:Evaluation Studies as Topic; D005234:Fatty Liver / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D007150:Immunohistochemistry; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index