Diagnostic value of acoustic radiation force impulse imaging and acoustic radiation force impulse ratio index for quantitative evaluating the degree of liver fibrosis in non-alcoholic fatty liver disease patients / 中华医学超声杂志（电子版）

ABSTRACT

Objective To investigate the diagnostic value of the acoustic radiation force impulse (ARFI) imaging technology and AST/PLT ratio index (APRI) for the assessment of the liver fibrosis in non-alcoholic fatty liver disease (NAFLD) patients.Method One hundred and thirty-six patients with NAFLD were included from May 2012 to May 2015 in the Third People's Hospital of Shenzhen.The subjects underwent liver biopsy,liver function and blood count test,as well as real-time ultrasonic elastography examination.The measurements of real-time ultrasonic elastography by ARFI technology used an ultrasonic instrument ACUSON S2000.The APRI was calculated according to the following formula,APRI=AST/PLT.ARFI and APRI were compared by correlation with liver fibrosis stage in NAFLD.Referring to the histologic fibrosis stage on liver biopsy,all the ARFI and the APRI value were assessed by using receiver operating characteristic (ROC) curve analysis.The corresponding cut-off values,sensitivity and specificity were also calculated and compared.One hundred and thirty-six patients with non alcoholic fatty liver disease were included in this study.Both of ARFI and APRI index were measured and calculated,and the results were compared with the pathological examination as gold standard.Results All patients underwent ARFI test.Compared with the patients with S0 and S 1,the ARFI of S4 were decreased significantly and the difference was statistically significant (both P ＜ 0.05).There was no significant difference in APRI index (P ＞ 0.05) among different stages of fibrosis.ROC curve of different diagnosis methods were drawn..The area under the ROC curve of diagnosing S2,S3 and S4 or higher stages nonalcoholic fatty liver disease by ARFI were 0.714,0.765,0.853,and corresponding value of APRI were 0.653,0.577 and 0.611.Compared with the APRI index,the area under the ROC curve of the ARFI technique in evaluating the degree of liver fibrosis in non alcoholic fatty liver disease was increased significantly,and the area under the curve of S4 was the highest.The cut-offARFI index of diagnosing severe hepatic fibrosis was 1.362 m/s.Conclusions As a non-invasive technology,ARFI is more accurate in evaluating liver fibrosis in patients with NAFLD than APRI.ARFI technology has potential value for quantitative evaluation of the liver fibrosis for NAFLD.