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Korean J Hepatol > Volume 15(1); 2009 > Article
The Korean Journal of Hepatology 2009;15(1): 42-51.
doi: https://doi.org/10.3350/kjhep.2009.15.1.42
The usefulness of transient elastography to diagnose cirrhosis in patients with alcoholic Liver disease
Sang Gyune Kim, M.D., Young Seok Kim, M.D., Seung Won Jung, M.D., Hee Kyung Kim, M.D.1, Jae Young Jang, M.D., Jong Ho Moon, M.D., Hong Soo Kim, M.D., Joon Seong Lee, M.D., Moon Sung Lee, M.D., Chan Sup Shim, M.D., Boo Sung Kim, M.D.
Institute for Digestive Research, Department of Internal Medicine, and 1Pathology, SoonChunHyang University College of Medicine, Bucheon and Seoul, Korea
Abstract
Backgrounds/Aims: It is not easy to differentiate between patients with cirrhosis and those with alcoholic liver disease. Liver biopsy is generally considered the gold standard for assessing hepatic fibrosis; however, this protocol frequently carries a risk of severe complications and false-negative results. Transient elastography (Fibroscan, Echosens, Paris, France), which is a noninvasive method of measuring liver stiffness, has become available for assessing liver fibrosis. Liver stiffness reportedly differs markedly with the cirrhosis etiology. The aim of this study was thus to determine the diagnostic accuracy of the Fibroscan in the detection of cirrhosis in patients with alcoholic liver disease.
Methods:
We enrolled 45 patients with alcoholic liver disease. Fibroscan, abdominal ultrasonography, aspartate aminotransferase/platelet ratio index (APRI), and liver biopsy were performed on all patients. Fibrosis stage was assessed using the Batts-Ludwig scoring system.
Results:
The stage of fibrosis (F1-F4) was distributed among the cohort as follows: 5 patients at F1, 4 patients at F2, 7 patients at F3, and 29 patients at F4. Liver stiffness differed significantly between each fibrosis stage (P<0.001). For the diagnosis of cirrhosis, the area under the receiver operating characteristic curve was 0.97 for transient elastography (95% confidence interval, CI, 0.93-1.01), 0.81 for ultrasonography (95% CI, 0.68-0.94), and 0.83 for APRI score (95% CI, 0.70-0.95). The optimal cut-off value of liver stiffness for detecting cirrhosis was 25.8 kPa, with a sensitivity of 90% and a specificity of 87%.
Conclusions:
Transient elastography is a useful method for diagnosing cirrhosis in patients with alcoholic liver disease. (Korean J Hepatol 2008;15:42-51)
KeyWords: Elasticity imaging techniques; Liver cirrhosis; Liver diseases, Alcoholic; Fibrosis
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