| Background:Liver fibrosis is a repair response of the body to chronic liver injury that is a total of pathological changes of the chronic liver disease. Liver biopsy is still the gold standard for the diagnosis of liver fibrosis, but because of the traumatic operation, sampling errors and so on,it is limited by certain restrictions in clinical applications.Therefore, looking for a accurate, reliable, non-invasive diagnostic method is a research hotspot at home and abroad in recent years. The stiffness of the region of interest can be measured by AixPlorer real-time shear wave elastography using supersonic shear imaging(SSI), in order to determine the degree of liver fibrosis. The study about this at home is still small. As we all know,there are many patients with hepatitis B in our country, and most of them died of liver cirrhosis and its complications annually.The vast majority of domestic research on the diagnosis of liver fibrosis is for patients with hepatitis B.With the development of the hepatitis B prevention work, the incidence of hepatitis B decreased significantly compared with the previous, and the incidence of other liver disease increased year by year like autoimmune liver disease.Therefore, the value of real-time shear wave elastography diagnosing liver fibrosis of autoimmune liver disease needs further study. Objective:To investigate the correlation between liver stiffness by supersonic shear imaging (SSI) and serum fibrosis markers, including direct indicators and indirect indicators and liver pathology.To evaluate the value of supersonic shear imaging(SSI) for diagnosing liver fibrosis in autoimmune liver disease.Methods:This study included70patients with a diagnosis of autoimmune liver disease in the First Affiliated Hospital of Zhengzhou University from May,2011to July,2012,all of them underwent serological markers of liver fibrosis,liver biopsy and SSI.The correlation between liver stiffness and serologic index and the staging of liver pathology was analyzed.A Receive Operating Characteristic(ROC)curve was drawn and the area under the curve(AUROC)was analyzed to determine the cutoff value,sensitivity,specificity,positive predictive value and negative predictive value of SSI for diagnosing different stages of liver fibrosis.The results were dealt with SPSS software.Results:1.The liver stiffness was closely related to PCIII, IV-C, LN and HA(P＜0.05), the correlation coefficient were0.339,0.365,0.409and0.450;2.AST,GGT,ALB and aspartate aminotransferase to platelet ratio index(APRI) were significantly correlated with liver stiffness(p＜0.05).Correlation coefficient were0.374,0.339,-0.481,0.380.ALT and GLB were not(p＞0.05);3.The liver stiffness of different stages had statistically significantly difference (H=23.704, p＜0.01); The liver stiffness was closely related to the staging of liver pathology (P＜0.05), the correlation coefficient was0.564;4.The AUROC of diagnosing moderate liver fibrosis and severe liver fibrosis and early cirrhosis with SSI were0.77and0.97,the cutoff value were17.01Kpa and38.25Kpa,the sensitivity were0.77and1.00,the specificity were0.64and0.95. Conclusions:1.There is a good correlation between the liver stiffness by SSI and serum fibrosis markers(including direct indicators and indirect indicators) and the staging of liver pathology, SSI can be dynamically monitoring liver fibrosis in progress to assess the degree of liver fibrosis.2.SSI is valuable for diagnosing the moderate liver fibrosis and much higher stage,especially the severe liver fibrosis and early cirrhosis.It can be used as an alternative of liver biopsy to the patients who were diagnosed as the severe liver fibrosis or higher stage and had risks with liver biopsy in clinical work. |
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