Evaluation Of Diagnostic Efficacy And Its Influencing Factors In Chronic Hepatitis B Liver Fibrosis By Shear Wave Elastography

Objective:To evaluate the diagnostic efficiency and influencing factors of chronic hepatitis B liver fibrosis by real-time shear wave elastography.Methods: Real-time shear wave elastography was performed on patients with chronic hepatitis B who were treated at Shengjing Hospital affiliated to China Medical University from January 2016 to September 2017(liver biopsy was performed in one week and staged by Metavir pathology)At the same time,the general data of patients and serological test results were collected.The receiver operating characteristic curve(ROC curve)was used to evaluate the accuracy and the best diagnostic value of real-time shear-wave elastography in diagnosis of liver fibrosis.Logistic regression analysis of factors that affect the accuracy of real-time shear wave elastography in the diagnosis of staging of liver fibrosis,including age,gender,chest wall thickness,grade of liver inflammation,HBV-related viral indicators and metabolic-related indicators,and the impact of factors Sexual analysis.Results:A total of 147 patients were included in this study.The histological diagnosis of hepatic fibrosis was the standard for hepatic fibrosis.The area under the ROC curve(AUC)for the diagnosis of hepatic fibrosis?F1,?F2,?F3,and ?F4 in SWE was 0.824,0.880,0.914,and 0.986,the best diagnostic cut-off values were 6.1 Kpa,7.0 Kpa,8.1Kpa,and 10.0 Kpa,respectively.Sensitivity was 91.0%,91.7%,87.0%,and 88.9%,respectively.The specificities were 66.0%,82.8%,66.0%,and 94.9%,respectively.The positive predictive values were 85.0%,78.6%,48.3%,and 53.3%,respectively.The negative predictive values were 77.5%,93.5%,97.2%,and 99.2%,respectively.Hepatic inflammation grading is a variable that affects the diagnostic accuracy of shear wave elastography(Exp(B)= 0.535,P = 0.028).It has a significant impact on the assessment of F0 and F2 liver fibrosis,and it is most significant at F0(Exp(B)=1.809,P=0.014<0.05).In liver fibrosis stage F0,liver stiffness values increased with the grade of liver inflammation(r=0.678,F=38.309,P<0.001).Conclusion:SWE measurement of liver elasticity value has good diagnostic efficacy in assessing liver fibrosis staging,and assessing the accuracy of hepatic fibrosis staging is affected by liver inflammation grade.In the diagnosis of F0 and F2 liver fibrosis,assessing the accuracy of hepatic fibrosis staging is significantly affected by the grade of hepatic inflammation,and it is most significant when assessing F0 liver fibrosis.When liver fibrosis stage is F0 stage,the liver elasticity value increases with the increase of liver inflammation level.Age,gender,abdominal wall thickness,HBe Ag,AST,and ALT had no significant effect on the accuracy of SWE in assessing liver fibrosis in patients with chronic hepatitis B.