title: Non-invasive assessment of liver fibrosis in patients with alcoholic liver disease using acoustic radiation force impulse elastography.
abstract: OBJECTIVE
  To investigate the diagnostic performance of the acoustic radiation force impulse (ARFI) elastography for the assessment of the liver fibrosis in alcoholic liver disease (ALD).
  
  
  METHODS
  We included 112 patients with ALD in whom liver biopsy, ARFI elastography, and aspartate-to-platelet ratio index (APRI) measurements were performed.
  
  
  RESULTS
  ARFI elastography correlated significantly with histological fibrosis (r = 0.685, P < 0.001) in patients with ALD. The diagnostic accuracies expressed as areas under receiver operating characteristic (AUROC) curves for ARFI elastography and APRI were 0.846 and 0.763 for the diagnosis of significant fibrosis (S ≥ 2), 0.875 and 0.688 for the diagnosis of severe fibrosis (S ≥ 3), and 0.893 and 0.648 for the diagnosis of liver cirrhosis, respectively. The AUROC values of ARFI elastography were significantly better than those of APRI for predicting severe fibrosis (P = 0.02) and cirrhosis (P = 0.04). The optimum cutoff values for ARFI elastography were 1.33 m/s for S ≥ 2, 1.40 m/s for S ≥ 3, and 1.65 m/s for S = 4 in patients with elevated alanine aminotransferase (ALT) levels; these decreased to 1.24 m/s for S ≥ 2, 1.27 m/s for S ≥ 3, and 1.41 m/s for S = 4 in patients with normal ALT.
  
  
  CONCLUSIONS
  ARFI elastography is an acceptable method for predicting the severity of fibrosis in patients with ALD. ARFI elastography is influenced by elevated aminotransferase levels in ALD.
authors.affiliation: Department of Ultrasound, The 302 Hospital of PLA, No. 100, Xi Si Huan Zhong Lu, Beijing, 100039, China, zdk002@163.com.
authors.forename: Dakun
authors.initials: D
authors.lastname: Zhang
authors.forename: Peng
authors.initials: P
authors.lastname: Li
authors.forename: Min
authors.initials: M
authors.lastname: Chen
authors.forename: Liping
authors.initials: L
authors.lastname: Liu
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Zhao
authors.forename: Ruifang
authors.initials: R
authors.lastname: Wang
mesh_terms: D000328:Adult; D019540:Area Under Curve; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008108:Liver Diseases, Alcoholic / Q000000981:diagnostic imaging; D008297:Male; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity