title: Discordance between conventional ultrasonography and ElastPQ for assessing hepatic fibrosis in chronic hepatitis B: frequency and independent factors.
abstract: OBJECTIVE
  To investigate the frequency of discordance and to identify factors associated with discordance between ultrasonographic and elastographic grades for assessing hepatic fibrosis in Asian patients with chronic hepatitis B.
  
  
  METHODS
  Three hundred thirty-four patients with chronic hepatitis B for which both conventional ultrasonography and liver stiffness measurements using elastography were available were included. Patients were graded as 'normal', 'chronic liver disease', or 'liver cirrhosis' by ultrasonography, and as 'no significant fibrosis', 'significant fibrosis', or 'liver cirrhosis' by elastography, and the results of these two modalities were compared. Logistic regression analyses were performed to identify independent factors associated with discordant results.
  
  
  RESULTS
  Of the 334 patients, 153 (45.8 %), 115 (34.4 %), and 66 (19.8 %) patients were 'normal', 'chronic liver disease', and 'liver cirrhosis', respectively, based on the ultrasonographic grades, and 290 (86.8 %), 29 (8.7 %), and 15 (4.5 %) patients were 'no significant fibrosis,' 'significant fibrosis', and 'liver cirrhosis', respectively, based on the elastographic values. Among them, 173 (51.8 %) showed discordance with respect to severity of hepatic fibrosis. In multivariable analysis, discordance was more frequent in patients with ultrasonographic grades of 'chronic liver disease' [adjusted odds ratio (AOR), 1924; P < 0.001] and 'liver cirrhosis' (AOR, 4498; P < 0.001), whereas patients with an elastographic grade of 'liver cirrhosis' showed a negative association with discordance (AOR, 0.002; P = 0.007).
  
  
  CONCLUSIONS
  There was a high rate of discordance between hepatic fibrosis grades determined by ultrasonography and elastography. Considering the accuracy of liver stiffness evaluation by elastography, conventional ultrasonography might overestimate hepatic fibrosis in chronic hepatitis B.
authors.affiliation: Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea. misung70@gmail.com.
authors.forename: Mi Sung
authors.initials: MS
authors.lastname: Kim
authors.affiliation: Department of Gastroenterology and Hepatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Byung Ik
authors.initials: BI
authors.lastname: Kim
authors.affiliation: Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Heon-Ju
authors.initials: HJ
authors.lastname: Kwon
authors.affiliation: Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Hae Won
authors.initials: HW
authors.lastname: Park
authors.affiliation: Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Hee-Jin
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Department of Gastroenterology and Hepatology, Dankook University Hospital, 108 Pyong dong, Jongro-gu, Seoul, 110-746, Korea.
authors.forename: Ki Bae
authors.initials: KB
authors.lastname: Bang
authors.affiliation: Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Hyun Pyo
authors.initials: HP
authors.lastname: Hong
authors.affiliation: Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Rho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D019694:Hepatitis B, Chronic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007723:Korea; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult
keywords: Elastography; Liver fibrosis; Ultrasonography