Elastography for Hepatic Fibrosis Severity in Chronic Hepatitis B or C

February 9, 2011

316635 & Ausgabe=254865 & ProduktNr=232833

Vol. 5, No. 1, 2011

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Article (PDF 148 KB)

Open Access

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Published: January 2011

Elastography for Hepatic Fibrosis Severity in Chronic Hepatitis B or C

-Vasiliki Papageorgioua, V. Papatheodoridisa, Spilios

Manolakopoulosa, Emmanuel Tsochatzisa, Hariklia Kranidiotia, Georgia Kafirib,

Athanasios I. Archimandritisa

a2nd Department of Internal Medicine, Medical School of Athens University, and

bDepartment of Pathology, ‘Hippokration’ General Hospital of Athens, Athens,

Greece

Address of Corresponding Author

Case Rep Gastroenterol 2011;5:63-72 (DOI: 10.1159/000316635)

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Abstract

Aims: To assess the value of transient elastography for predicting significant

fibrosis or cirrhosis in chronic hepatitis B or C (CHB or CHC) patients.

Methods: 75 patients (CHB: 45, CHC: 32) were included. All underwent

elastography and liver biopsy concurrently. Biopsies were evaluated using

Ishak’s classification. Fibrosis was mild, moderate or severe/cirrhosis when

scores were 0–1 (n = 30), 2–3 (n = 20), 4–6 (n = 25), respectively. Results:

Median liver stiffness values were higher in patients with severe fibrosis or

cirrhosis than in those with moderate or mild fibrosis (14.8 vs. 6.4 vs. 5.3

kPa, p < 0.001). The diagnostic accuracy of elastography for severe fibrosis and

cirrhosis was excellent [area under the receiver operating characteristic

(AUROC) curve 0.938 vs. 0.948], but it was not optimal for mild fibrosis (AUROC

0.78). Values of 7.5, 9.0 and 12 kPa had a sensitivity and specificity for

severe fibrosis/cirrhosis of 96, 84 and 60%, and 76, 90 and 94%, respectively.

The median stiffness value in cirrhotic patients (score 5–6) was 16.6 kPa

(7.7–48). No differences in accuracy of elastography between CHB or CHC patients

were found. Cutoff was 12.5 kPa for cirrhosis; 10/75 patients (13%) were

misclassified. Conclusion: Transient elastography has an excellent diagnostic

accuracy for severe fibrosis and cirrhosis in CHB and CHC, but the cutoffs need

further evaluation.

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Author Contacts

V. Papatheodoridis, MD

2nd Department of Internal Medicine, Medical School of Athens University

‘Hippokration’ General Hospital, 114 Vas Sofias ave

GR–115 27 Athens (Greece)

Tel. +30 210 777 4742, Fax +30 210 770 6871, E-Mail gepapath@...

February 9, 2011