Primary biliary cirrhosis degree assessment by acoustic radiation force impulse imaging and hepatic fibrosis indicators.
OBJECTIVE
To evaluate the assessment of primary biliary cirrhosis degree by acoustic radiation force impulse imaging (ARFI) and hepatic fibrosis indicators.


METHODS
One hundred and twenty patients who developed liver cirrhosis secondary to primary biliary cirrhosis were selected as the observation group, with the degree of patient liver cirrhosis graded by Child-Pugh (CP) score. Sixty healthy individuals were selected as the control group. The four indicators of hepatic fibrosis were detected in all research objects, including hyaluronic acid (HA), laminin (LN), type III collagen (PC III), and type IV collagen (IV-C). The liver parenchyma hardness value (LS) was then measured by ARFI technique. LS and the four indicators of liver fibrosis (HA, LN, PC III, and IV-C) were observed in different grade CP scores. The diagnostic value of LS and the four indicators of liver fibrosis in determining liver cirrhosis degree with PBC, whether used alone or in combination, were analyzed by receiver operating characteristic (ROC) curve.


RESULTS
LS and the four indicators of liver fibrosis within the three classes (A, B, and C) of CP scores in the observation group were higher than in the control group, with C class > B class > A class; the differences were statistically significant (P < 0.01). Although AUC values of LS within the three classes of CP scores were higher than in the four indicators of liver fibrosis, sensitivity and specificity were unstable. The ROC curves of LS combined with the four indicators of liver fibrosis revealed that: AUC and sensitivity in all indicators combined in the A class of CP score were higher than in LS alone, albeit with slightly decreased specificity; AUC and specificity in all indicators combined in the B class of CP score were higher than in LS alone, with unchanged sensitivity; AUC values (0.967), sensitivity (97.4%), and specificity (90%) of all indicators combined in the C class of CP score were higher than in LS alone (0.936, 92.1%, 83.3%).


CONCLUSIONS
The diagnostic value of PBC cirrhosis degree in liver cirrhosis degree assessment by ARFI combined with the four indicators of serum liver fibrosis is of satisfactory effectiveness and has important clinical application value.
Hai-Chun Zhang, Rong-Fei Hu, Ting Zhu, Ling Tong, Department of Ultrasound, Huashan Hospital Baoshan Branch Affiliated to Fudan University, Shanghai 200431, China.
Hai-Chun
HC
Zhang
Hai-Chun Zhang, Rong-Fei Hu, Ting Zhu, Ling Tong, Department of Ultrasound, Huashan Hospital Baoshan Branch Affiliated to Fudan University, Shanghai 200431, China.
Rong-Fei
RF
Hu
Hai-Chun Zhang, Rong-Fei Hu, Ting Zhu, Ling Tong, Department of Ultrasound, Huashan Hospital Baoshan Branch Affiliated to Fudan University, Shanghai 200431, China.
Ting
T
Zhu
Hai-Chun Zhang, Rong-Fei Hu, Ting Zhu, Ling Tong, Department of Ultrasound, Huashan Hospital Baoshan Branch Affiliated to Fudan University, Shanghai 200431, China.
Ling
L
Tong
Hai-Chun Zhang, Rong-Fei Hu, Ting Zhu, Ling Tong, Department of Ultrasound, Huashan Hospital Baoshan Branch Affiliated to Fudan University, Shanghai 200431, China.
Qiu-Qin
QQ
Zhang
D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D016022:Case-Control Studies; D024061:Collagen Type III / Q000032:analysis; D024141:Collagen Type IV / Q000032:analysis; D018450:Disease Progression; D054459:Elasticity Imaging Techniques; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D006820:Hyaluronic Acid / Q000032:analysis; D007797:Laminin / Q000032:analysis; D008099:Liver / Q000737:chemistry* / Q000000981:diagnostic imaging*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000378:metabolism*; D008105:Liver Cirrhosis, Biliary / Q000150:complications / Q000000981:diagnostic imaging* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012720:Severity of Illness Index
D015415:Biomarkers; D024061:Collagen Type III; D024141:Collagen Type IV; D007797:Laminin; D006820:Hyaluronic Acid
Acoustic radiation force imaging technology; Diagnostic value; Hepatic fibrosis index; Primary biliary cirrhosis