Liver fibrosis with two-dimensional shear-wave elastography in patients with autoimmune hepatitis

ABSTRACT

Background

Two-dimensional shear-wave elastography (2D-SWE) is an ultrasound-based real-time 2D-SWE imaging technique for noninvasive assessment of liver fibrosis. The diagnostic performance of 2D-SWE for assessing liver fibrosis in patients with autoimmune hepatitis (AIH) has not been reported.

Aims

To evaluate the diagnostic performance of 2D-SWE and serologic tests including the aspartate amino transferase-to-platelet ratio index (APRI) and fibrosis-4 index (FIB-4) for liver fibrosis staging in patients with AIH.

Methods

103 patients were retrospectively collected. Liver fibrosis was staged according to the Scheuer scoring system. The areas under the receiver operating characteristic curves (AUROCs) were used to assess the accuracy of 2D-SWE and serum fibrosis models for staging liver fibrosis.

Results

Liver stiffness measured by 2D-SWE had a strong correlation with histological fibrosis stage (r = 0.71, P < 0.0001). The AUROCs of liver stiffness in detecting significant fibrosis, severe fibrosis, and cirrhosis were 0.84, 0.84, and 0.94, respectively. The AUROCs of liver stiffness for detecting significant fibrosis and severe fibrosis were higher than those of APRI (0.57, 0.56) and FIB-4 (0.63, 0.66), respectively. The cut‐off liver stiffness values for predicting significant fibrosis, severe fibrosis, and cirrhosis were 10.0, 15.8, and 19.3 kPa, respectively.

Conclusions

2D-SWE shows promising diagnostic performance for staging liver fibrosis in patients with AIH.

KEYWORDS:

• Autoimmune hepatitis
• liver fibrosis
• liver stiffness
• noninvasive method
• two-dimensional shear-wave elastography

Declaration of interest

Xian Xing was involved in the conception and design, analysis, and interpretation of the data and the drafting of the paper. Yulin Yan was involved in the conception and design, analysis, and interpretation of the data and revising the paper. Yi Shen and Mei Xue collected data. Xiaoze Wang was involved in data management and revising the paper. Xuefeng Luo was involved in the conception and design, revising the paper. Li Yang was involved in the conception and design and the final approval of the version of the manuscript to be published. All authors agree to be accountable for all aspects of the work. The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

The study was funded by Post-Doctor Research Project, West China Hospital, Sichuan University [No. 2019HXBH045] and 1·3·5 project for disciplines of excellence–Clinical Research Incubation Project, West China Hospital, Sichuan University [No. 2019HXFH055].