Liver Stiffness Measurement by Transient Elastography in Clinical Practice

Abstract

The aim of our study was to evaluate the results of transient elastography assessment of liver stiffness (LS) in various categories of patients.

Material and method. We performed transient elastography in 986 patients. We evaluated: the percentage of cases in which valid measurements could be obtained; the values of LS in 40 patients with no history of chronic liver disease ("normal" patients); 44 inactive HBsAg carriers; 173 patients with proven liver cirrhosis; and the correlation between liver biopsy results and LS in 93 patients with chronic HCV hepatitis.

Results. We obtained valid measurements of LS in 94.6% of the 986 cases. Male gender, younger age and low BMI were positive predictive factors for obtaining valid measurements. The mean values of LS were: 5.2ą1.3 kPa in "normal" patients, 5.8ą2.6 kPa in inactive HBsAg carriers, 37.2ą20.9 kPa in patients with liver cirrhosis. In patients with chronic HCV hepatitis, we found that the mean value of LS in those with METAVIR F=2 was 8.5ą4.2 kPa, higher than in those with F<2: 5.3ą1.4 kPa (p=0.0017). In patients with F=3, the mean value of LS was 11.1ą4.3 kPa, significantly higher than in patients with F<3: 6.1ą2.5 kPa (p<0.0001).

Conclusions. Liver stiffness, as a marker of fibrosis, can be evaluated by means of transient elastography in a great majority of patients. It is a useful method for the exclusion of significant liver fibrosis and for predicting liver cirrhosis. As compared to liver biopsy, transient elastography can discern significant fibrosis from no or mild fibrosis.