Abstract
ObjectivesThis study aim to investigate the diagnostic accuracy of shear wave elastography (SWE) for diagnosing nonalcoholic steatohepatitis (NASH) and staging fibrosis in a cohort patients confirmed nonalcoholic fatty liver disease (NAFLD) by liver biopsy.MethodsA total of 86 NAFLD patients and 17 normal-control were enrolled. The performance of SWE to diagnose NASH and stage fibrosis was evaluated on the basis of histopathological inflammation grades and fibrosis stages according to Kleiner/Brunt et al.’s criteria classification, and compared to previous reported four noninvasive serum fibrotic scores, coupled with the k-fold-cross-validation and Delong test. Meanwhile, influence of steatosis on liver stiffness measurements (LSMs) of SWE was also studied.ResultsLSMs of SWE proved to be an excellent diagnostic indicator for detecting NASH (AUROC＝0.85), and fibrotic NASH: ≥F2 stage (AUROC＝0.92), ≥F3 stage (AUROC＝0.94) and =F4 stage (AUROC ＝0.94) with the cutoff values were 7.55, 7.65, 8.25 and 11.80 kPa, respectively. Compared with serum fibrotic scores, SWE had the highest AUROC for predicting ≥F2, ≥F3, =F4 by Delong test (all P＜0.05). No statistic differences of LSMs were found among different steatosis levels (P=0.29).ConclusionThe stiffness reconstructions based on SWE could be used to noninvasively identify NASH and stage fibrosis in NAFLD patients. Moreover, the diagnosis efficiency of LSMs on SWE could not be influenced by steatosis.
Liver stiffness quantification in biopsyproven nonalcoholic fatty liver disease patients using shear wave elastography in comparison with transient elastography
