The Value Of Acoustic Radiation Force Impulse In Quantitative Evaluation Of Liver Parenchyma Lesions

BackgroundIn lesions of the hepatic parenchyma, different etiology had its corresponding pathological presentation. Lipid metabolism disorders and relative overnutrition would result in fatty liver, repeated hepatitis viruses infection would result in chronic viral hepatitis. Diffuse parenchymal liver disease was the common imaging presentation of many developing and progressive chronic hepatic diseases, which reflected the common characteristic of chronic liver fibrosis. Evaluation and control of diseases were related to the progress and prognosis of chronic hepatic diseases, especially for viral hepatitis, alcoholic hepatic disease, hepatic disease in schistosomiasis, fatty liver and etc, an irreversible progress to the hepatic cirrhosis would happen without treating promptly. At present, most imaging researches combined liver biopsy and serological test to evaluation the liver stiffness of liver parenchyma lesions which had become the focus of research, but these was rare research concerning the relationship between the liver stiffness tested by quantitative imaging and its corresponding etiology at great length.ObjectivesTo detect the liver stiffness of chronic hepatitis B induced hepatic fibrosis and nonalcoholic simple fatty liver quantitatively by ARFI imaging and compare differences between them, the clinical significance of VTQ values was investigated.MethodsThirty cases with nonalcoholic simple fatty liver,132cases with chronic hepatitis B induced hepatic fibrosis (including31cases with stage IV liver cirrhosis), and30normal cases as the control group received ARFI quantification analysis by Siemens Virtual TouchTM Tissue Quantification(VTQ). The tissue stiffness was depicted by VTQ value, which demonstrated the shear-wave speed. We analyzed. all measurements obtained from region of interest(ROI) which was4.5to5.5cm below the skin. Variance analysis was adopted to compare VTQ values among groups, cut-off values of each group was determined by ROC Curve in the differential diagnosis of diffuse parenchymal liver disease. Meanwhile, one-way analysis of variance(ANOVA) was adopted to compare shear-wave speeds between subgroups of chronic hepatitis B induced hepatic fibrosis.ResultsThere was significant difference of VTQ values among groups. The results were as follows:VTQ values of hepatic B chronic> normal control group>nonalcoholic simple fatty liver(P<0.05), SNK multiple comparison between subgroups showed significant differences except for S0&S1between subgroups of hepatic B chronic(P<0.05). ConclusionsAcoustic radiation force impulse quantification is adopted to evaluate the liver stiffness of chronic hepatic fibrosis and fatty liver. VTQ value is one of the quantitative index, which can be adopted to differentiate chronic hepatitis B induced hepatic fibrosis, nonalcoholic simple fatty liver and normal liver. According to the correlation between the liver VTQ values and pathological grade, VTQ values can be adopted to stage the chronic hepatitis B induced hepatic fibrosis approximately, which can reduce the liver biopsy significantly and provide objective index for liver parenchyma quantitative assessment.