The Study Of Hepatic Fibrosis In Patients With Chronic Liver Disease By Acoustic Radiation Force Impulse

Objective: To investigate the value and cutoff value of Acoustic radiation force impulse(ARFI) in different hepatic fibrosis stages for patients with Chronic liver disease.Methods: 130 cases were examined by ARFI and did biopsied on ultrosound-guided from January 2015 to October 2015 in the Third Hospital of Hebei Medical University.Results: 130 patients were studied, of which, 75 male and 55 female, the ratio of male and female was 15:11. The mean age of all the subjects was 48 years. The average body mass index(BMI) was 24.5kg/m(18-29) [IBM= mass(kg)/height2(m)2]. The fibrosis of the S0, S1, S2, S3 and S4 stage accordingly accounted for 15(12%), 30(23%), 38(29%), 33(25%) and 14(11%). Analysis of variance(ANOVA) was carried out that the statistically differences existed in other stages of different fibers except for S0 and S1. S?S1, S?S2, S?S3, S?S4 were taken as the cutoff values respectively to evaluate the elasticity values of hepatic fibrosis in different stages according to the receiver operating characteristic(ROC) curve. The result was that the values of hepatic fibrosis of the section of the area under concentration-time curve(AUC) of the right anterior lobe is respectively 0.822, 0.878, 0.907, 0.985. The elasticity value of the section of the AUC of the right anterior lobe was with the highest accuracy, and with the increasing of the fibrosis the elasticity values was more and more accurate. S?S1, S?S2, S?S3, S?S4 were taken as the cutoff values to evaluate the values of hepatic elasticity in different liver segment during various fibrosis stages according to the ROC curves. The results were as follows: the cutoff values were 1.35m/s, 1.45m/s, 1.57m/s, 1.78m/s, the Youden index were: 0.63, 0.69, 0.73, 0.82, the sensitivity and specificity of each grade were: 0.70 and 0.93, 0.80 and 0.89, 0.89 and 0.84, 0.95 and 0.87.Conclusion:1 ARFI can assess different degrees of hepatic fibrosis.2 The accuracy of ARFI technique in the right lobe of liver was more accurate than that in the left lobe of the liver, and the highest accuracy is in the right anterior segment.3 The values measured by ARFI technology for advanced fibrosis patients with liver elasticity measured value is more accurate.4 Corresponding relations between varying degrees of hepatic fibrosis and ARFI elastic cutoff values are S?S1: 1.35m/s, S?S2: 1.45m/s, S?S3: 1.57m/s, S?S4: 1.78m/s.