title: Acoustic radiation force impulse (ARFI) and high-frequency ultrasound of the liver surface for the diagnosis of compensated liver cirrhosis.
abstract: OBJECTIVE
  To evaluate the diagnostic value of acoustic radiation force impulse (ARFI) and high-frequency ultrasound of the liver surface, using histology as a gold standard for the diagnosis of compensated liver cirrhosis.
  
  
  METHODS
  73 patients without ascites undergoing liver biopsy were included in the study. The left and right liver lobes were examined with ARFI and high-frequency ultrasound. Liver surface irregularity was quantified using image analysis software to calculate the difference between the real surface and the approximated physiological surface through a 20 mm standardized line.
  
  
  RESULTS
  There is a significant difference between cirrhotic and non-cirrhotic patients for both quantified liver surface (QLS) and ARFI (p < 0.001). The mean values for QLS of the left lobe were 0.71 ± 0.24 mm and 1.17 ± 0.80 mm, of the right lobe 0.56 ± 0.26 mm and 0.87 ± 0.26 mm for non-cirrhotic and cirrhotic patients, respectively. The mean values of ARFI measurements of the left lobe were 2.04 ± 0.76 m/s and 2.85 ± 0.81 m/s, of the right lobe 1.65 ± 0.61 m/s and 3.02 ± 0.77 m/s for non-cirrhotic and cirrhotic patients, respectively. Diagnostic accuracy (AUROC) was 0.78/0.80 for QLS and 0.77/0.91 for ARFI of the left/right lobe, respectively. ARFI of the right lobe is significantly better than ARFI of the left (p = 0.023) or QLS of the left (p = 0.025)/right (p = 0.046) lobe of the liver.
  
  
  CONCLUSIONS
  Assessment of liver surface irregularity by high-frequency ultrasound (QLS) is a useful diagnostic test for the assessment of compensated liver cirrhosis. ARFI of the right liver lobe is significantly better than high-frequency ultrasound (QLS of the left/right lobe of the liver) and ARFI of the left lobe of the liver.
authors: Departement of Internal Medicine 1, University of Erlangen.
authors: L
authors: L
authors: Pfeifer
authors: Departement of Internal Medicine 1, University of Erlangen.
authors: R S
authors: RS
authors: Goertz
authors: Departement of Internal Medicine 1, University of Erlangen.
authors: J
authors: J
authors: Sturm
authors: Institut of Pathology, Universtiy of Erlangen.
authors: D
authors: D
authors: Wachter
authors: Institut of Pathology, Universtiy of Erlangen.
authors: M O
authors: MO
authors: Riener
authors: Institut of Medical Informatics, Biometry and Epidemiology, University of Erlangen.
authors: J
authors: J
authors: Schwitulla
authors: Innere Medizin, Kreisklinik Ebersberg.
authors: T
authors: T
authors: Bernatik
authors: Departement of Internal Medicine 1, University of Erlangen.
authors: M F
authors: MF
authors: Neurath
authors: Departement of Internal Medicine 1, University of Erlangen.
authors: D
authors: D
authors: Strobel
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012680:Sensitivity and Specificity; D012984:Software