November 2017 Vol. 5 No.11

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Original Research Article

Real-time Elastography (RTE) for assessment of liver fibrosis in patients with chronic viral hepatitis

Daniel Doykov^* and Vladimir Andonov

Second Department of Internal Diseases, Medical University of Plovdiv, Gastroenterology Clinic, University Hospital Kaspela

*Corresponding Author's Email: daniel_doykov@abv.bg,
Phone: 00359887375459

Accepted November 13, 2017

Abstract

The assessment of the degree of liver stiffness is important in the treatment of liver diseases. The various types of ultrasound elastography are relatively well studied. Transient Elastography (TE) is a proven method of assessment of liver stiffness and possesses the properties of a prognostic indicator. In contrast to this method, the significance of strain elastography used to assess the degree of liver stiffness remains insufficiently established. RTE elastography was conducted in 144 patients. 34 of them were with chronic viral Hepatitis C, 80 with chronic viral Hepatitis B and 30 healthy individuals as control group. The biomarkers APRI, Fibroindex, Forn’s index, FIB-4, Fibrotest were examined. In all patients outside of the control group, a liver biopsy was performed for histological evaluation of fibrosis. The RT-generated elastographic imaging was subjected to qualitative analysis by a specially developed program and the derived Liver Fibrosis Index (LFI) was compared to histological and laboratory data. The value of LFI increases as fibrosis progresses. LFI is significantly different in the cases of moderate fibrosis (F0-2) and advanced fibrosis (F3, 4). LFI shows a good correlation in determining advanced fibrosis and good reproducibility of the results. LFI was found to be an independent prognostic factor in patients with chronic liver disease. Strain elastography can be used to determine advanced liver fibrosis without influence of hepatic inflammation, unlike other serology markers of liver fibrosis. RTE is probably a prognostic factor in chronic liver diseases.

Key words: Real time liver elastography, strain liver elastography, liver stiffness measure