Korean J Hepatol.  2009 Mar;15(1):42-51. 10.3350/kjhep.2009.15.1.42.

The usefulness of transient elastography to diagnose cirrhosis in patients with alcoholic liver disease

• Kim SG
• Kim YS
• Jung SW
• Kim HK
• Jang JY
• Moon JH
• Kim HS
• Lee JS
• Lee MS
• Shim CS
• Kim BS

• KMID: 1776813
• DOI: http://doi.org/10.3350/kjhep.2009.15.1.42

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.

Keyword

Elasticity imaging techniques; Liver cirrhosis; Liver diseases, Alcoholic; Fibrosis

MeSH Terms

Adult
Aspartate Aminotransferases/blood
Elasticity Imaging Techniques/*methods
Female
Fibrosis
Hepatitis, Alcoholic/complications/*ultrasonography
Humans
Liver/pathology/ultrasonography
Liver Cirrhosis/complications/*ultrasonography
Male
Middle Aged
Platelet Count
ROC Curve