Association between shear wave liver elastography and fibrosis index in chronic viral hepatitis B patients

Harley Septian; Nyoman Srie  Laksminingsih; Made Widhi  Asih; I Gde Raka Widiana; I Ketut  Mariadi

doi:10.15562/ijbs.v17i1.415

Association between shear wave liver elastography and fibrosis index in chronic viral hepatitis B patients

Harley Septian ,

Nyoman Srie Laksminingsih ,

Made Widhi Asih ,

I Gde Raka Widiana ,

I Ketut Mariadi ,

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DOI: https://doi.org/10.15562/ijbs.v17i1.415 |
Published: 2023-03-08

Abstract

Background: Chronic viral hepatitis B causes chronic inflammatory process, hepatocyte damage, progressive fibrosis, and irreversible liver damage, leading to high morbidity. There are two methods of diagnosing liver fibrosis, invasive (biopsy) and non-invasive, including radiological examination using the elastography method and hematological examination. This study aims to determine the relationship between the elasticity of liver parenchyma using the Shear Wave Elastography (SWE) method and fibrosis index in chronic viral hepatitis B patients.

Methods: This research is a cross-sectional study using 68 samples that met the inclusion criteria. The 2D-SWE examination was blindly performed by two observers using a convex transducer probe with frequencies ranging from 1.2 to 6 MHz. Data were analyzed using SPSS version 20.0 for Windows.

Results: In our study, there was a significant moderate positive correlation between the elasticity of liver parenchyma and the fibrosis index performed by both observers (r=0.52; p < 0.001). After controlling confounding variables, a higher correction was obtained (r=0.61), suggesting a change from moderate to strong correlation (p<0.05).

Conclusion: There was a positive and significant correlation between the elasticity of liver parenchyma and fibrosis index.

References

Standring S. Gray's Anatomy: The Anatomical Basis of Clinical Practice. 41st ed. Elsevier Limited, London 2016.
Rasche A, Sander A, Corman VM, Drexler JF. Evolutionary biology of human hepatitis viruses. J Hepatol. 2019;70(3):501–520.
Baseline Health Research Indonesia (Riskesdas) 2013. Indonesian Ministry of Health. Jakarta; 2014.
Theise ND, Bodenheimer HC, Guido M. Viral Hepatitis in: MacSween's Pathology of the Liver. 7th ed. Elsevier Ltd, Philadelphia 2018.
Ebrahimi H, Naderian M, Sohrabpour AA. New Concepts on Pathogenesis and Diagnosis of Liver Fibrosis; A Review Article. Middle East J Dig Dis. 2016;8(3):166–178.
Cheng JYK, Wong GLH. Advances in the diagnosis and treatment of liver fibrosis. Hepatoma Res. 2017;3(8):156-169.
Doyley MM, Parker KJ. Elastography: general principles and clinical applications. Ultrasound Clin. 2014;9(1):1–11.
Shiina T, Nightingale KR, Palmeri ML, Hall TJ, Bamber JC, Barr RG, et al. WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 1: Basic principles and terminology. Ultrasound Med Biol. 2015;41(5):1126–1147.
Barr RG, Wilson SR, Rubens D, Garcia-Tsao G, Ferraioli G. Update to the Society of Radiologists in Ultrasound Liver Elastography Consensus Statement. Radiol. 2020;296(2):263–274.
Yusuf F, Abubakar A, Maghfirah D, Baswin A. Relationship red distribution width to platelet ratio with fibrosis degrees based on transient elastography in chronic hepatitis B patients. Bali Medical Journal. 2021;10(2):793-797.
Vallet-Pichard A, Mallet V, Nalpas B, Verkarre V, Nalpas A, Dhalluin-Venier V, et al. FIB-4: An inexpensive and accurate marker of fibrosis in HCV infection. Comparison with liver biopsy and FibroTest. Hepatol. 2007;46(1):32–36.
Acharya P, Chouhan K, Weiskirchen S, Weiskirchen R. Cellular Mechanisms of Liver Fibrosis. Front Pharmacol. 2021;12:671640.
Rockey DC. Liver Fibrosis Reversion After Suppression of Hepatitis B Virus. Clin Liver Dis. 2016;20(4):667–679.
Karic U, Pesic-Pavlovic I, Stevanovic G, Korac M, Nikolic N, Radovanovic-Spurnic A, et al. FIB-4 and APRI scores for predicting severe fibrosis in chronic hepatitis C - A developing country's perspective in DAA era. J Infect Dev Ctries. 2018;12(3):178–182.
Gennisson JL, Deffieux T, Fink M, Tanter M. Ultrasound elastography: Principles and techniques. Diagn Interv Imaging. 2013;94(5):487–495.
Xiong M, Li J, Yang S, Zeng F, Ji Y, Liu J, et al. Influence of Gender and Reproductive Factors on Liver Fibrosis in Patients with Chronic Hepatitis B Infection. Clin Transl Gastroeneterol. 2019;10(10):e00085.

[1] Standring S. Gray's Anatomy: The Anatomical Basis of Clinical Practice. 41st ed. Elsevier Limited, London 2016.

[2] Rasche A, Sander A, Corman VM, Drexler JF. Evolutionary biology of human hepatitis viruses. J Hepatol. 2019;70(3):501–520.

[3] Baseline Health Research Indonesia (Riskesdas) 2013. Indonesian Ministry of Health. Jakarta; 2014.

[4] Theise ND, Bodenheimer HC, Guido M. Viral Hepatitis in: MacSween's Pathology of the Liver. 7th ed. Elsevier Ltd, Philadelphia 2018.

[5] Ebrahimi H, Naderian M, Sohrabpour AA. New Concepts on Pathogenesis and Diagnosis of Liver Fibrosis; A Review Article. Middle East J Dig Dis. 2016;8(3):166–178.

[6] Cheng JYK, Wong GLH. Advances in the diagnosis and treatment of liver fibrosis. Hepatoma Res. 2017;3(8):156-169.

[7] Doyley MM, Parker KJ. Elastography: general principles and clinical applications. Ultrasound Clin. 2014;9(1):1–11.

[8] Shiina T, Nightingale KR, Palmeri ML, Hall TJ, Bamber JC, Barr RG, et al. WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 1: Basic principles and terminology. Ultrasound Med Biol. 2015;41(5):1126–1147.

[9] Barr RG, Wilson SR, Rubens D, Garcia-Tsao G, Ferraioli G. Update to the Society of Radiologists in Ultrasound Liver Elastography Consensus Statement. Radiol. 2020;296(2):263–274.

[10] Yusuf F, Abubakar A, Maghfirah D, Baswin A. Relationship red distribution width to platelet ratio with fibrosis degrees based on transient elastography in chronic hepatitis B patients. Bali Medical Journal. 2021;10(2):793-797.

[11] Vallet-Pichard A, Mallet V, Nalpas B, Verkarre V, Nalpas A, Dhalluin-Venier V, et al. FIB-4: An inexpensive and accurate marker of fibrosis in HCV infection. Comparison with liver biopsy and FibroTest. Hepatol. 2007;46(1):32–36.

[12] Acharya P, Chouhan K, Weiskirchen S, Weiskirchen R. Cellular Mechanisms of Liver Fibrosis. Front Pharmacol. 2021;12:671640.

[13] Rockey DC. Liver Fibrosis Reversion After Suppression of Hepatitis B Virus. Clin Liver Dis. 2016;20(4):667–679.

[14] Karic U, Pesic-Pavlovic I, Stevanovic G, Korac M, Nikolic N, Radovanovic-Spurnic A, et al. FIB-4 and APRI scores for predicting severe fibrosis in chronic hepatitis C - A developing country's perspective in DAA era. J Infect Dev Ctries. 2018;12(3):178–182.

[15] Gennisson JL, Deffieux T, Fink M, Tanter M. Ultrasound elastography: Principles and techniques. Diagn Interv Imaging. 2013;94(5):487–495.

[16] Xiong M, Li J, Yang S, Zeng F, Ji Y, Liu J, et al. Influence of Gender and Reproductive Factors on Liver Fibrosis in Patients with Chronic Hepatitis B Infection. Clin Transl Gastroeneterol. 2019;10(10):e00085.

Association between shear wave liver elastography and fibrosis index in chronic viral hepatitis B patients

Abstract

References

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