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Objective To explore the diagnostic value of virtual touch tissue quantification (VTQ) for the assessment of liver fibrosis in patients with chronic hepatitis B.Methods VTQ was prospectively performed in 181 patients with chronic hepatitis B and a shear wave velocity (Vs) indirectly reflecting liver stiffness was obtained for each patient.With the gold standards of fibrotic stages and inflammation grades,the relationship between Vs,fibrotic stages and inflammation grades was evaluated.Results A relatively high correlation existed between Vs and liver fibrotic stages (r ＝ 0.812,P ＜ 0.001).Significant differences existed among groups with different fibrotic stages except for groups SO vs.S1 and S1 vs.S2 (P ＜ 0.05).The areas under the ROC curve were 0.971,0.96l,0.969 and 0.908 for Vs predicting S≥S1,S≥S2,S≥S3 and S =S4 fibrosis respectively.Moderate correlation existed between Vs and inflammation grades (r =0.476,P =0.000).Conclusion Capable of staging liver fibrosis and preliminarily grading inflammation,VTQ is helpful for the early diagnosis of liver fibrosis and assessment of therapeutic follow-up and prognosis in patients with chronic hepatitis B.
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Accurate assessment of liver fibrosis plays an important role in its treatment options,monitoring and clinical prognosis.Ultrasound elastography indirectly assesses liver fibrosis by non-invasively detecting the stiffness of liver parenchyma,with the advantages of high accuracy and easy operation,ultrasound elastography is gradually challenging the gold standard fine needle aspiration biopsy to assess liver fibrosis.This paper reviews the clinical value of ultrasound elastography in evaluating liver fibrosis.
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Objective To investigate the usefulness of acoustic radiation force impulse (ARFI) elastography for noninvasive evaluation of liver fibrosis in rats.Methods A total of 70 male Wistar rats were included in the group for dimethylnitrosamine (DMN)-induced liver injury,and 10 saline-injected rats were used as normal control.Hepatic injury was induced by a single intraperitoneal injection of DMN at a dose of 50 mg/kg of body weight.Several rats in the group with DNM injected and the normal control group were randomly selected and sacrificed at each of the following post-injection time:day 5,7,10,14,21,24,and 28.And their livers were taken for pathology analysis.All the rats underwent ARFI elastography before sacrificed in order to acquire a shear wave velocity (Vs) to represent liver stiffness.Correlation between Vs and the histological finding was analysed.ResultsAmong 58 successfully modeled rats,9,13,14 and 12 rats were found to be with S1,S2,S3 and S4 of liver fibrosis pathologically,respectively.And 10 rats were found to be with severe inflammatory activity without any fibrosis.Values of Vs increased with the stage of liver fibrosis ( P ＜0.05).There was a significant correlation between Vs and stage of liver fibrosis ( r =0.947,P =0.000).The areas under ROC curve for the diagnosis of fibrosis S≥S1,S≥S2,S≥S3 and S=S4 were 0.983,0.995,0.999 and 0.964,respectively;for the cutoff values of Vs were 1.59 m/s,2.13 m/s,2.33 m/s and 2.51 m/s,respectively,the sensitivity was 95.8％,92.3％,100％ and 84.6％,and specificity was 100％,100％,96.9％ and 95.6％,respectively.The values of Vs in the group with severe inflammatory activity were significantly higher than those in the control group ( P =0.000).ConclusionsARFI has a relatively high value in the evaluation of liver fibrfosis in rats,while severe inflammatory activity may affect its accuracy.
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Objective To evaluate the clinical values of acoustic radiation force impulse(ARFI) elastography for liver fibrosis on hepatopath patients.Methods ARFI elastography was prospectively performed on 99 patients prepared to undergo hepatic surgery to get a shear wave velocity(Vs) which was the representative of liver stiffness.The fibrosis stages,inflammation grades and steatosis grades were evaluated histologically after surgery.Values of Vs were compared with the histological results.Results Values of Vs with fibrosis stage 0-4 was (1.14 ± 0.22) m/s,(1.30 ± 0.22) m/s,(1.36 ± 0.38) m/s,(1.47 ± 0.37)m/s and (1.87 ± 0.08) m/s,respectively.A significant difference was observed among them (P ＜0.001).There was a certain correlation between Vs and fibrosis stage(r =0.541,P ＜0.001).Vs was a significant predictor of stage ≥3 fibrosis with an area under the ROC curve of 0.812,sensitivity 73.2％ and specificity 81.4％ when 1.40 m/s was the cutoff value (P ＜ 0.001).Values of Vs with inflammation grade 0-3 was (1.17 ± 0.16)m/s,(1.43 ± 0.36) m/s,(1.59 ± 0.53) m/s and (1.89 ± 0.59) m/s,respectively,which were significantly different (P ＜ 0.001).A certain correlation was observed between Vs and inflammation grade(r =0.383,P ＜0.001).Values of Vs with steatosis grade 0-4 was (1.61 ±0.42) m/s,(1.47±0.58) m/s,(1.56 ± 0.71)m/s,1.13 m/s and (0.94 ± 0.95) m/s.Obvious difference didn't exist between Vs and steatosis grade (P =0.286).Obvious correlation wasn't observed between them,either (r =-0.177,P =0.080).Conclusions ARFI elastography has a certain value for the evaluation of liver fibrosis,while inflammation grade may affect its performance.
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Objective To investigate the relationship between ultrasound features and pathological types of primary hepatic lymphoma (PHL).Methods Ultrasound and pathological features in 26 cases of PHL were analyzed retrospectively.Results The most common presentation of PHL was a solitary lesion,which occurred in about 57.7％ (15/26) of cases,followed by multiple lesions in about 26.9％ (7/26) of patients,and least commonly as diffuse infiltration patterns in about 15.4％ (4/26) cases.The first two types were similar and usually demonstrated as hypoechoic lesions to the surrounding normal liver parenchyma in 86.4％ (19/22) of cases on ultrasound.All the cases were B-cell non-Hodgkin lymphoma proven by histological and immunohistochemical examinations.The diffuse pattern demonstrated diffuse hepatomegaly without nodular,which were T-cell non-Hodgkin lymphoma proven by histological and immunohistochemical examinations.Conclusions PHL could be divided into single,multiple and diffuse types on ultrasound.The single and multiple types mainly present as hypoechoic lesions and the diffuse type shows hepatomegaly on ultrasound,which are closely related to histology and T or B-cell phenotype on immunohistochemical examination.