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Copyright © 2019 Geng-lin Zhang et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. https://creativecommons.org/licenses/by/4.0/

Abstract

Background and Aims. Concordance between transient elastography (TE) and ultrasonography (US) in assessing liver fibrosis in patients with chronic hepatitis B (CHB) and concurrent nonalcoholic fatty liver disease (NAFLD) has been rarely studied. This study aimed to evaluate the individual and combined performances of TE and US in assessing liver fibrosis and cirrhosis. Patients and Methods. Consecutive CHB patients with NAFLD were prospectively enrolled. TE and US examinations were performed, with liver biopsy as a reference standard. Receiver operating characteristic (ROC) curves were obtained to evaluate the diagnostic performance. Differences between the areas under the ROC curves (AUCs) were compared using DeLong’s test. Results. TE and US scores correlated significantly with the histological fibrosis staging scores. TE was significantly superior to US in the diagnosis of significant fibrosis (AUC, 0.84 vs 0.73; P=0.02), advanced fibrosis (AUC, 0.95 vs 0.76; P<0.001), and cirrhosis (AUC, 0.96 vs 0.71; P<0.001). Combining TE with US did not increase the accuracy of detecting significant fibrosis, advanced cirrhosis, or cirrhosis (P=0.62, P=0.69, and P=0.38, respectively) compared to TE alone. However, TE combined with US significantly increased the positive predictive value for significant fibrosis when compared to TE alone. The optimal cut-off values of TE for predicting advanced fibrosis and cirrhosis were 8.7 kPa and 10.9 kPa, with negative predictive values of 92.4% and 98.7%, respectively. Conclusions. TE is useful for predicting hepatic fibrosis and excluding cirrhosis in CHB patients with NAFLD. A combination of TE and US does not improve the accuracy in assessing liver fibrosis or cirrhosis.

Details

Title
Transient Elastography and Ultrasonography: Optimal Evaluation of Liver Fibrosis and Cirrhosis in Patients with Chronic Hepatitis B Concurrent with Nonalcoholic Fatty Liver Disease
Author
Geng-lin, Zhang 1   VIAFID ORCID Logo  ; Qi-yi, Zhao 1   VIAFID ORCID Logo  ; Chao-shuang, Lin 1   VIAFID ORCID Logo  ; Zhao-xia, Hu 1 ; Zhang, Ting 2   VIAFID ORCID Logo  ; Zhi-liang Gao 3   VIAFID ORCID Logo 

 Department of Infectious Diseases, The Third Affiliated Hospital of Sun-Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Liver Disease, The Third Affiliated Hospital of Sun-Yat-sen University, Guangzhou, China 
 Department of Ultrasound, The Third Affiliated Hospital of Sun-Yat-sen University, Guangzhou, China 
 Department of Infectious Diseases, The Third Affiliated Hospital of Sun-Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Liver Disease, The Third Affiliated Hospital of Sun-Yat-sen University, Guangzhou, China; Key Laboratory of Tropical Disease Control, Sun-Yat-sen University, Ministry of Education, Guangzhou, China 
Editor
Filippo Schepis
Publication year
2019
Publication date
2019
Publisher
John Wiley & Sons, Inc.
ISSN
23146133
e-ISSN
23146141
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2175234598
Copyright
Copyright © 2019 Geng-lin Zhang et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. https://creativecommons.org/licenses/by/4.0/