Serial change of liver stiffness measured by acoustic radiation force impulse imaging in chronic liver disease: correlation with biochemical markers.
OBJECTIVE
In patients with chronic diffuse liver diseases, liver fibrosis severity is an important element for prognosis and for selecting therapy. Acoustic radiation force impulse (ARFI) imaging techniques were recently developed to measure liver fibrosis, but their specificity is impaired by cholestasis, inflammation, or edema in acute hepatitis. Herein, our objectives were to evaluate serial changes in shear wave velocity (SWV) and to correlate these changes with biochemical activity.


METHODS
This study included 108 patients who underwent ARFI because of viral hepatitis [hepatitis B (HBV) or C (HCV)] with serial follow-up after 3-6 months at our institution between August 2011 and May 2013. Based on baseline and follow-up ARFI, we divided patients with HBV and HCV into two groups: a decreasing SWV group and a non-decreasing SWV group. We evaluated serial SWV changes and correlated these changes with biochemical activity changes.


RESULTS
The patients were divided into SWV groups as follows: decreasing SWV group (HBV, n = 23; HCV, n = 7) and non-decreasing SWV group (HBV, n = 40; HCV, n = 38). In both HBV and HVC patients, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were significantly decreased at follow-up in the decreasing SWV group.


CONCLUSIONS
The liver stiffness value assessed by ARFI became lower over time in patients who had decreasing AST and ALT levels. According to this study, ARFI overestimates fibrosis grade in patients with high AST and ALT. Thus, assessment of liver fibrosis by ARFI elastography should include consideration of biochemical markers such as AST and ALT levels and additional follow-up using ARFI elastography.
Department of Radiology, Dong-A University Hospital, Dongdaesindong 3ga, Seo-gu, Pusan, 602-715, South Korea.
Mansu
M
Choi
Department of Radiology, Dong-A University Hospital, Dongdaesindong 3ga, Seo-gu, Pusan, 602-715, South Korea. risual@dau.ac.kr.
Heejin
H
Kwon
Department of Radiology, Dong-A University Hospital, Dongdaesindong 3ga, Seo-gu, Pusan, 602-715, South Korea.
Jinhan
J
Cho
Department of Radiology, Dong-A University Hospital, Dongdaesindong 3ga, Seo-gu, Pusan, 602-715, South Korea.
Jongyoung
J
Oh
Department of Radiology, Dong-A University Hospital, Dongdaesindong 3ga, Seo-gu, Pusan, 602-715, South Korea.
Kyungjin
K
Nam
Department of Radiology, Dong-A University Hospital, Dongdaesindong 3ga, Seo-gu, Pusan, 602-715, South Korea.
Myungjin
M
Kang
Department of Radiology, Dong-A University Hospital, Dongdaesindong 3ga, Seo-gu, Pusan, 602-715, South Korea.
Eunju
E
Kang
Department of Internal Medicine, Dong-A University Hospital, Dongdaesingdong 3ga, Seo-gu, Pusan, 602-715, South Korea.
Sangyeong
S
Han
Department of Internal Medicine, Dong-A University Hospital, Dongdaesingdong 3ga, Seo-gu, Pusan, 602-715, South Korea.
Sungwook
S
Lee
D000328:Adult; D000368:Aged; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D019694:Hepatitis B, Chronic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D019698:Hepatitis C, Chronic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult
Diagnostic procedure; Edema; Inflammation; Liver; Ultrasound