Differences in liver fibrosis between patients with chronic hepatitis B and C: evaluation by acoustic radiation force impulse measurements at 2 locations.
OBJECTIVE
The purpose of this study was to evaluate liver fibrosis by acoustic radiation force impulse (ARFI) measurements at 2 locations in patients with chronic hepatitis B and C.


METHODS
A total of 204 consecutive patients (146 male and 58 female) with chronic hepatitis B (n = 121) and C (n = 83) who underwent liver biopsy were enrolled. All patients received ARFI measurements at 2 locations in the right intercostal space on the same day as biopsy.


RESULTS
There was no difference in median ARFI values between detection locations. However, a significant difference was found for low and high values between locations (median ± SD, 1.38 ± 0.43 versus 1.56 ± 0.55 m/s; P < .001). By receiver operating characteristic (ROC) curve analysis for a METAVIR fibrosis score of F4 (cirrhosis), the lower value of 2 measurements had the highest area under the ROC curve (0.750), followed by the mean value (0.744) and the higher value (0.730). Patients with hepatitis C had a higher area under the ROC curve than patients with hepatitis B (0.824 versus 0.707) for predicting liver cirrhosis. By logistic regression analysis, ARFI was the best modality for predicting liver cirrhosis in hepatitis C, and conventional sonography was the best modality in hepatitis B (P < .001). The ARFI value in patients with hepatitis B was significantly influenced by liver inflammation (P = .019).


CONCLUSIONS
Acoustic radiation force impulse imaging is the modality of choice for predicting liver cirrhosis in chronic hepatitis C, whereas conventional sonography is still the modality of choice in chronic hepatitis B.
Departments of Gastroenterology and Hepatology (D.-I.T., W.-J.J., C.-C.W., C.-H.H., S.-M.L., C.-T.C., W.-T.C.) and Medical Imaging and Intervention (Y.-L.W.), Chang Gung Memorial Hospital, Taipei, Taiwan; Department of Public Health and Center of Biostatistics, Chang Gung University College of Medicine, Tao-Yuan, Taiwan (P.-K.T.); Division of Molecular and Genomic Medicine, National Health Research Institute, Taipei, Taiwan (S.-F.H.); and Department of Medical Imaging and Radiological Sciences, College of Medicine, Institute for Radiological Research, Chang Gung University, Tao-Yuan, Taiwan (Y.-L.W.) tai48978@cloud.cgmh.org.tw weiting@cloud.cgmh.org.tw.
Dar-In
DI
Tai
Departments of Gastroenterology and Hepatology (D.-I.T., W.-J.J., C.-C.W., C.-H.H., S.-M.L., C.-T.C., W.-T.C.) and Medical Imaging and Intervention (Y.-L.W.), Chang Gung Memorial Hospital, Taipei, Taiwan; Department of Public Health and Center of Biostatistics, Chang Gung University College of Medicine, Tao-Yuan, Taiwan (P.-K.T.); Division of Molecular and Genomic Medicine, National Health Research Institute, Taipei, Taiwan (S.-F.H.); and Department of Medical Imaging and Radiological Sciences, College of Medicine, Institute for Radiological Research, Chang Gung University, Tao-Yuan, Taiwan (Y.-L.W.).
Pei-Kwei
PK
Tsay
Departments of Gastroenterology and Hepatology (D.-I.T., W.-J.J., C.-C.W., C.-H.H., S.-M.L., C.-T.C., W.-T.C.) and Medical Imaging and Intervention (Y.-L.W.), Chang Gung Memorial Hospital, Taipei, Taiwan; Department of Public Health and Center of Biostatistics, Chang Gung University College of Medicine, Tao-Yuan, Taiwan (P.-K.T.); Division of Molecular and Genomic Medicine, National Health Research Institute, Taipei, Taiwan (S.-F.H.); and Department of Medical Imaging and Radiological Sciences, College of Medicine, Institute for Radiological Research, Chang Gung University, Tao-Yuan, Taiwan (Y.-L.W.).
Wen-Juei
WJ
Jeng
Departments of Gastroenterology and Hepatology (D.-I.T., W.-J.J., C.-C.W., C.-H.H., S.-M.L., C.-T.C., W.-T.C.) and Medical Imaging and Intervention (Y.-L.W.), Chang Gung Memorial Hospital, Taipei, Taiwan; Department of Public Health and Center of Biostatistics, Chang Gung University College of Medicine, Tao-Yuan, Taiwan (P.-K.T.); Division of Molecular and Genomic Medicine, National Health Research Institute, Taipei, Taiwan (S.-F.H.); and Department of Medical Imaging and Radiological Sciences, College of Medicine, Institute for Radiological Research, Chang Gung University, Tao-Yuan, Taiwan (Y.-L.W.).
Chia-Chan
CC
Weng
Departments of Gastroenterology and Hepatology (D.-I.T., W.-J.J., C.-C.W., C.-H.H., S.-M.L., C.-T.C., W.-T.C.) and Medical Imaging and Intervention (Y.-L.W.), Chang Gung Memorial Hospital, Taipei, Taiwan; Department of Public Health and Center of Biostatistics, Chang Gung University College of Medicine, Tao-Yuan, Taiwan (P.-K.T.); Division of Molecular and Genomic Medicine, National Health Research Institute, Taipei, Taiwan (S.-F.H.); and Department of Medical Imaging and Radiological Sciences, College of Medicine, Institute for Radiological Research, Chang Gung University, Tao-Yuan, Taiwan (Y.-L.W.).
Shiu-Feng
SF
Huang
Departments of Gastroenterology and Hepatology (D.-I.T., W.-J.J., C.-C.W., C.-H.H., S.-M.L., C.-T.C., W.-T.C.) and Medical Imaging and Intervention (Y.-L.W.), Chang Gung Memorial Hospital, Taipei, Taiwan; Department of Public Health and Center of Biostatistics, Chang Gung University College of Medicine, Tao-Yuan, Taiwan (P.-K.T.); Division of Molecular and Genomic Medicine, National Health Research Institute, Taipei, Taiwan (S.-F.H.); and Department of Medical Imaging and Radiological Sciences, College of Medicine, Institute for Radiological Research, Chang Gung University, Tao-Yuan, Taiwan (Y.-L.W.).
Chien-Hao
CH
Huang
Departments of Gastroenterology and Hepatology (D.-I.T., W.-J.J., C.-C.W., C.-H.H., S.-M.L., C.-T.C., W.-T.C.) and Medical Imaging and Intervention (Y.-L.W.), Chang Gung Memorial Hospital, Taipei, Taiwan; Department of Public Health and Center of Biostatistics, Chang Gung University College of Medicine, Tao-Yuan, Taiwan (P.-K.T.); Division of Molecular and Genomic Medicine, National Health Research Institute, Taipei, Taiwan (S.-F.H.); and Department of Medical Imaging and Radiological Sciences, College of Medicine, Institute for Radiological Research, Chang Gung University, Tao-Yuan, Taiwan (Y.-L.W.).
Shi-Ming
SM
Lin
Departments of Gastroenterology and Hepatology (D.-I.T., W.-J.J., C.-C.W., C.-H.H., S.-M.L., C.-T.C., W.-T.C.) and Medical Imaging and Intervention (Y.-L.W.), Chang Gung Memorial Hospital, Taipei, Taiwan; Department of Public Health and Center of Biostatistics, Chang Gung University College of Medicine, Tao-Yuan, Taiwan (P.-K.T.); Division of Molecular and Genomic Medicine, National Health Research Institute, Taipei, Taiwan (S.-F.H.); and Department of Medical Imaging and Radiological Sciences, College of Medicine, Institute for Radiological Research, Chang Gung University, Tao-Yuan, Taiwan (Y.-L.W.).
Cheng-Tang
CT
Chiu
Departments of Gastroenterology and Hepatology (D.-I.T., W.-J.J., C.-C.W., C.-H.H., S.-M.L., C.-T.C., W.-T.C.) and Medical Imaging and Intervention (Y.-L.W.), Chang Gung Memorial Hospital, Taipei, Taiwan; Department of Public Health and Center of Biostatistics, Chang Gung University College of Medicine, Tao-Yuan, Taiwan (P.-K.T.); Division of Molecular and Genomic Medicine, National Health Research Institute, Taipei, Taiwan (S.-F.H.); and Department of Medical Imaging and Radiological Sciences, College of Medicine, Institute for Radiological Research, Chang Gung University, Tao-Yuan, Taiwan (Y.-L.W.).
Wei-Ting
WT
Chen
Departments of Gastroenterology and Hepatology (D.-I.T., W.-J.J., C.-C.W., C.-H.H., S.-M.L., C.-T.C., W.-T.C.) and Medical Imaging and Intervention (Y.-L.W.), Chang Gung Memorial Hospital, Taipei, Taiwan; Department of Public Health and Center of Biostatistics, Chang Gung University College of Medicine, Tao-Yuan, Taiwan (P.-K.T.); Division of Molecular and Genomic Medicine, National Health Research Institute, Taipei, Taiwan (S.-F.H.); and Department of Medical Imaging and Radiological Sciences, College of Medicine, Institute for Radiological Research, Chang Gung University, Tao-Yuan, Taiwan (Y.-L.W.).
Yung-Liang
YL
Wan
D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications / Q000000981:diagnostic imaging*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
acoustic radiation force impulse; gastrointestinal ultrasound; hepatitis B; hepatitis C; liver fibrosis