Non-invasive measurement of liver and pancreas fibrosis in patients with cystic fibrosis.
BACKGROUND
Patients with cystic fibrosis (CF) have a relevant morbidity and mortality caused by CF-related liver-disease. While transient elastography (TE) is an established elastography method in hepatology centers, Acoustic-Radiation-Force-Impulse (ARFI)-Imaging is a novel ultrasound-based elastography method which is integrated in a conventional ultrasound-system. The aim of the present study was to evaluate the prevalence of liver-fibrosis in patients with CF using TE, ARFI-imaging and fibrosis blood tests.


METHODS
106 patients with CF were prospectively included in the present study and received ARFI-imaging of the left and right liver-lobe, ARFI of the pancreas TE of the liver and laboratory evaluation.


RESULTS
The prevalence of liver-fibrosis according to recently published best practice guidelines for CFLD was 22.6%. Prevalence of significant liver-fibrosis assessed by TE, ARFI-right-liver-lobe, ARFI-left-liver-lobe, Fibrotest, Fibrotest-corrected-by-haptoglobin was 17%, 24%, 40%, 7%, and 16%, respectively. The best agreement was found for TE, ARFI-right-liver-lobe and Fibrotest-corrected-by-haptoglobin. Patients with pancreatic-insufficiency had significantly lower pancreas-ARFI-values as compared to patients without.


CONCLUSIONS
ARFI-imaging and TE seem to be promising non-invasive methods for detection of liver-fibrosis in patients with CF.
Department of Internal Medicine 1, J.W. Goethe-University Hospital, Frankfurt, Germany. Mireen.Friedrich-Rust@kgu.de
Mireen
M
Friedrich-Rust
Nina
N
Schlueter
Christina
C
Smaczny
Olaf
O
Eickmeier
Martin
M
Rosewich
Kirstin
K
Feifel
Eva
E
Herrmann
Thierry
T
Poynard
Wolfgang
W
Gleiber
Christoph
C
Lais
Stefan
S
Zielen
Thomas O F
TO
Wagner
Stefan
S
Zeuzem
Joerg
J
Bojunga
D000293:Adolescent; D000328:Adult; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005355:Fibrosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000473:pathology*; D015995:Prevalence; D011446:Prospective Studies; D055815:Young Adult
ARFI; CF; Cirrhosis; Liver stiffness; Mucoviscidosis