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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 1
Jan.  2023
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Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(1): 97-103

Diagnostic value of real-time shear wave elastography for liver fibrosis in patients with autoimmune hepatitis

DOI: 10.3969/j.issn.1001-5256.2023.01.015

  • Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China

Research funding:

Science and Technology Project of Henan Province (212102310131)

More Information
  • Corresponding author: WEN Hongtao, wenhongtao68@163.com (ORCID: 0000-0002-3054-0468)
  • Received Date: 2022-06-13
  • Accepted Date: 2022-07-21
  • Published Date: 2023-01-20
    Abstract
  •   Objective  To explore the diagnostic value of Young's modulus obtained by real-time shear wave elastography (SWE) for liver fibrosis in autoimmune hepatitis (AIH) patients.  Methods  A total of 75 AIH patients in the First Affiliated Hospital of Zhengzhou University from January 2013 to April 2022 were retrospectively enrolled. Scheuer scoring system was used to evaluate degrees of liver fibrosis (S0-S4). By using pathological examination of liver tissues as the golden standard, the receiver operating characteristic curve (ROC) was plotted and the area under the curve (AUC) was used to evaluate the diagnostic value of SWE for the significant fibrosis (≥S2), advanced liver fibrosis (≥S3), and liver cirrhosis (S4), respectively. Independent sample t test was used for comparison of continuous data with normal distribution between the two groups. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups and Bonferroni method was used for further comparison between two groups. The Spearman correlation coefficient was used for correlation analysis. The logistic regression analysis was used to predict the impact factors in diagnosis accuracy.  Results  The Young's modulus measured by SWE was statistically significant different among various fibrosis groups (H=35.186, P < 0.001) although there was no statistical significance in patients' age and platelet, alanine aminotransferase, aspartate aminotransferase, total bilirubin, alkaline phosphatase, and glutamyl transpeptidase levels (all P > 0.05). The Young's modulus measurement was positively correlated with liver fibrosis (r=0.675, P < 0.05). The AUCs of SWE in the diagnosis of≥S2, ≥S3, and S4 were 0.839, 0.820 and 0.898, respectively and the corresponding optimum cut-off values were 9.2, 10.9, and 14.4 kPa, respectively. The overall concordance rate of the liver Young' s modulus measurements vs. fibrosis stages was 57.33%. Moreover, the alkaline phosphatase level was an independent predictor for diagnostic accuracy of SWE for stage 0-1 fibrosis (OR=1.009, 95%CI: 1.001-1.018, P=0.029).  Conclusion  The SWE possessed a diagnosis value for the significant fibrosis (≥S2), advanced liver fibrosis (≥S3) and liver cirrhosis (S4), although there was a low overall concordance rate in the liver Young's modulus measurements obtained using SWE vs. fibrosis stages.

     

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    • References(20)
  • [1]
    GRØNBAEK L, OTETE H, BAN L, et al. Incidence, prevalence and mortality of autoimmune hepatitis in England 1997-2015. A population-based cohort study[J]. Liver Int, 2020, 40(7): 1634-1644. DOI: 10.1111/liv.14480.
    [2]
    SHARMA R, VERNA EC, SIMON TG, et al. Cancer risk in patients with autoimmune hepatitis: a nationwide population-based cohort study with histopathology[J]. Am J Epidemiol, 2022, 191(2): 298-319. DOI: 10.1093/aje/kwab119.
    [3]
    WANG QX, YAN L, MA X. Autoimmune hepatitis in the Asia-Pacific area[J]. J Clin Transl Hepatol, 2018, 6(1): 48-56. DOI: 10.14218/JCTH.2017.00032.
    [4]
    MACK CL, ADAMS D, ASSIS DN, et al. Diagnosis and management of autoimmune hepatitis in adults and children: 2019 practice guidance and guidelines from the American Association for the Study of Liver Diseases[J]. Hepatology, 2020, 72(2): 671-722. DOI: 10.1002/hep.31065.
    [5]
    AKSAKAL M, OKTAR SO, SENDUR HN, et al. Diagnostic performance of 2D shear wave elastography in predicting liver fibrosis in patients with chronic hepatitis B and C: a histopathological correlation study[J]. Abdom Radiol (NY), 2021, 46(7): 3238-3244. DOI: 10.1007/s00261-021-03019-6.
    [6]
    HENNES EM, ZENIYA M, CZAJA AJ, et al. Simplified criteria for the diagnosis of autoimmune hepatitis[J]. Hepatology, 2008, 48(1): 169-176. DOI: 10.1002/hep.22322.
    [7]
    ALVAREZ F, BERG PA, BIANCHI FB, et al. International Autoimmune Hepatitis Group Report: review of criteria for diagnosis of autoimmune hepatitis[J]. J Hepatol, 1999, 31(5): 929-938. DOI: 10.1016/s0168-8278(99)80297-9.
    [8]
    WANG G, TANAKA A, ZHAO H, et al. The Asian Pacific Association for the Study of the Liver clinical practice guidance: the diagnosis and management of patients with autoimmune hepatitis[J]. Hepatol Int, 2021, 15(2): 223-257. DOI: 10.1007/s12072-021-10170-1.
    [9]
    Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the diagnosis and management of autoimmune hepatitis (2021)[J]. J Clin Hepatol, 2022, 38(1): 42-49. DOI: 10.3760/cma.j.cn112138-20211112-00796.

    中华医学会肝病学分会. 自身免疫性肝炎诊断和治疗指南(2021)[J]. 临床肝胆病杂志, 2022, 38(1): 42-49. DOI: 10.3760/cma.j.cn112138-20211112-00796.
    [10]
    WU XX, WANG T, DU SN, et al. Diagnostic value assessment of seven noninvasive diagnostic models in liver fibrosis and cirrhosis of patients with chronic hepatitis B[J]. China Med Herald, 2022, 19(10): 14-19. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202210003.htm

    吴小溪, 汪涛, 杜晟楠, 等. 7种无创诊断模型对慢性乙型肝炎肝纤维化及肝硬化的诊断价值评估[J]. 中国医药导报, 2022, 19(10): 14-19. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202210003.htm
    [11]
    CHENG DY, LI B, JI SB, et al. Application of transient elastography in noninvasive diagnosis of liver fibrosis[J/CD]. Chin J Liver Dis (Electronic Version), 2021, 13(4): 9-13. DOI: 10.3969/j.issn.1674-7380.2021.04.003.

    程丹颖, 李贲, 纪世博, 等. 瞬时弹性成像技术在肝纤维化无创诊断中的应用[J/CD]. 中国肝脏病杂志(电子版), 2021, 13(4): 9-13. DOI: 10.3969/j.issn.1674-7380.2021.04.003.
    [12]
    ZHOU X, RAO J, WU X, et al. Comparison of 2-D shear wave elastography and point shear wave elastography for assessing liver fibrosis[J]. Ultrasound Med Biol, 2021, 47(3): 408-427. DOI: 10.1016/j.ultrasmedbio.2020.11.013.
    [13]
    FANG C, KONSTANTATOU E, ROMANOS O, et al. Reproducibility of 2-dimensional shear wave elastography assessment of the liver: a direct comparison with point shear wave elastography in healthy volunteers[J]. J Ultrasound Med, 2017, 36(8): 1563-1569. DOI: 10.7863/ultra.16.07018.
    [14]
    Panel of Elastography Assessment of Liver Fibrosis, Study Group of Interventional Ultrasound, Society of Ultrasound in Medicine of Chinese Medical Association. Guidelines for clinical application of two-dimensional shear wave elastography in assessment of liver fibrosis in chronic hepatitis B[J]. J Clin Hepatol, 2018, 34(2): 255-261. DOI: 10.3969/j.issn.1001-5256.2018.02.008.

    中华医学会超声医学分会介入超声学组弹性成像评估肝纤维化专家组. 二维剪切波弹性成像评估慢性乙型肝炎肝纤维化临床应用指南[J]. 临床肝胆病杂志, 2018, 34(2): 255-261. DOI: 10.3969/j.issn.1001-5256.2018.02.008.
    [15]
    HERRMANN E, de LéDINGHEN V, CASSINOTTO C, et al. Assessment of biopsy-proven liver fibrosis by two-dimensional shear wave elastography: An individual patient data-based meta-analysis[J]. Hepatology, 2018, 67(1): 260-272. DOI: 10.1002/hep.29179.
    [16]
    XIAO G, ZHU S, XIAO X, et al. Comparison of laboratory tests, ultrasound, or magnetic resonance elastography to detect fibrosis in patients with nonalcoholic fatty liver disease: A meta-analysis[J]. Hepatology, 2017, 66(5): 1486-1501. DOI: 10.1002/hep.29302.
    [17]
    XING X, YAN Y, SHEN Y, et al. Liver fibrosis with two-dimensional shear-wave elastography in patients with autoimmune hepatitis[J]. Expert Rev Gastroenterol Hepatol, 2020, 14(7): 631-638. DOI: 10.1080/17474124.2020.1779589.
    [18]
    LIU BR, DONG X, HUANG LP. Diagnostic efficacy of shear wave elastography in evaluating chronic hepatitis B liver fibrosis and related influencing factors[J]. J Clin Hepatol, 2018, 34(11): 2329-2333. DOI: 10.3969/j.issn.1001-5256.2018.11.012.

    刘博儒, 董雪, 黄丽萍. 剪切波弹性成像评估慢性乙型肝炎肝纤维化的价值及影响因素[J]. 临床肝胆病杂志, 2018, 34(11): 2329-2333. DOI: 10.3969/j.issn.1001-5256.2018.11.012.
    [19]
    YAN Y, XING X, LU Q, et al. Assessment of biopsy proven liver fibrosis by two-dimensional shear wave elastography in patients with primary biliary cholangitis[J]. Dig Liver Dis, 2020, 52(5): 555-560. DOI: 10.1016/j.dld.2020.02.002.
    [20]
    ZENG J, HUANG ZP, ZHENG J, et al. Non-invasive assessment of liver fibrosis using two-dimensional shear wave elastography in patients with autoimmune liver diseases[J]. World J Gastroenterol, 2017, 23(26): 4839-4846. DOI: 10.3748/wjg.v23.i26.4839.
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