title: ARFI elastography in patients with chronic autoimmune liver diseases: A preliminary study.
abstract: OBJECTIVE
  Acoustic radiation force impulse (ARFI) is a new software-based technique that evaluates liver stiffness during B-mode ultrasonography. The purpose of this study was to evaluate the accuracy of ARFI in distinguishing patients with chronic autoimmune liver disease from healthy subjects.
  
  
  METHODS
  We enrolled 9 adult patients (8 women, 1 man; age 48.1 ± 12.8 years) with chronic autoimmune disease (primary biliary cirrhosis (PBC, n = 3), autoimmune hepatitis (AIH, n = 2), primary sclerosing cholangitis (PSC, n = 1) and overlap syndromes, (n = 3) who underwent a liver biopsy and 11 healthy volunteers (age 34.7 ± 10.4 years; 7 women, 4 men). Liver stiffness was evaluated and expressed as the shear wave velocity (SWV) in m/sec. We used a US scanner Siemens-Acuson S2000, evaluating the right liver lobe and the left liver lobe.
  
  
  RESULTS
  THE SWV WAS SIGNIFICANTLY HIGHER IN CASES (RIGHT LOBE: 1.51 ± 0.44; left lobe: 1.57 ± 0.40) than in controls (right lobe: 1.08 ± 0.10; left lobe: 1.12 ± 0.13) (right lobe: P = 0.002; left lobe: P = 0.013). We found no significant correlation between right and left lobe SWVs in cases (P = 0.779) or controls (P = 0.385). The SWV cut-off that best distinguished cases from controls was 1.25 m/sec (accuracy: AUC=0.885; sensitivity: 70.6%; specificity: 95.5%).
  
  
  CONCLUSIONS
  ARFI elastography is a noninvasive ultrasonographic technique that can differentiate healthy subjects from patients with fibrotic stages of chronic liver disease.
authors.affiliation: Department of Digestive System Disease and Internal Medicine, Saint Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Righi
authors.forename: E
authors.initials: E
authors.lastname: Fiorini
authors.forename: C
authors.initials: C
authors.lastname: De Molo
authors.forename: V
authors.initials: V
authors.lastname: Cipriano
authors.forename: F
authors.initials: F
authors.lastname: Cassani
authors.forename: L
authors.initials: L
authors.lastname: Muratori
authors.forename: M
authors.initials: M
authors.lastname: Lenzi
authors.forename: A M
authors.initials: AM
authors.lastname: Morselli Labate
authors.forename: C
authors.initials: C
authors.lastname: Serra
keywords: ARFI imaging; Autoimmune hepatitis; Primary biliary cirrhosis; Primary sclerosing cholangitis