Application Of Real-time Elastography And Fibro Scan In Evaluation Of Liver Fibrosis

Objective China is the hardest hit by chronic hepatitis B.Every year,hundreds of thousands of patients die from hepatitis B and related diseases.It can be transmitted through various routes such as maternal and child,blood products and application of blood,sexual contact,and damaged skin mucosa.Chronic hepatitis B has become a public health problem in China that cannot be ignored.Hepatic fibrosis is one of the basic pathological changes of hepatitis B.Its main pathological features are intrahepatic connective tissue hyperplasia and abnormal deposition of extracellular matrix.Liver fibrosis is a pathological consequence of various chronic damages and inflammations such as viruses,various autoimmune diseases,and cholestatic metabolic diseases.Part of patients with liver fibrosis can progress to cirrhosis and liver cancer.This is because extensively proliferating fibrous tissue will regenerate nodules to form pseudolobules,and liver fibrosis is difficult to reverse.However,early liver fibrosis lesions have a certain degree of reversibility.Therefore,early diagnosis and early treatment have important clinical significance for controlling liver fibrosis and preventing the deterioration of lesions.The current liver biopsy is still the“gold standard”for identifying the stage of liver fibrosis,however,because of its invasiveness and high fees,a large number of patients are difficult to accept,and the amount of liver tissue samples taken during each liver biopsy is limited,plus physician reading.Subjective influence,thus having certain limitations and subjectivity.In recent years,with the rapid development of imaging technology,elastography has become a non-invasive new technology for evaluating liver stiffness and is gradually being applied to clinical research.Currently used in clinical ultrasound elastography mainly include real-time tissue elastography(RTE),transient elastography(FibroScan,FS),real-time shear wave elastography(SWE),and acoustic radiation.Force pulse elastography(ARFI),etc.This article aims to investigate the value of RTE and FS in the evaluation of liver fibrosis in patients with chronichepatitis B.Methods The observation group was selected as 210 patients with chronic hepatitis B,and another 120 healthy volunteers in the control group.Ultrasound RTE and FS were performed on two groups of subjects using a Hitachi HI Vision Preims color Doppler ultrasound system equipped with RTE technology and a FibroScan 502 ultrasound diagnostic instrument manufactured by Echosens,France.The observation group was finally punctured.Biopsy to determine the degree of liver fibrosis.The liver fibrosis index(LF Index)and liver stiffness value(LSM)of the two groups were compared,and the relationship between RTE,FS and liver fibrosis was analyzed.Results The different of MEAN,SD,COMP,SKEW and AREA value of the control group and the observation group were significant(P<0.05).In the observation group,the MEAN,SD,COMP,SKEW,and AREA values of the F0 patients were not significantly different from those of the control group(P>0.05).The MEAN,SD,COMP,SKEW and AREA levels showed an increasing trend with the increase of liver fibrosis stage(F0 phase <F1 phase <F2 phase <F3 phase <F4 phase).The LF Index and LSM values of the control group and the observation group were significantly different(P<0.05),Index and LSM values increased with the increase of liver fibrosis stage.Correlation analysis showed that LF Index,LSM and liver fibrosis stage were positively correlated(P<0.05).Taking the F2 phase as the demarcation point,the area under the ROC curve(AUC value)of the LF Index and the LSM value respectively were 0.892(95% CI:0.758~0.925)and 0.905(95% CI:0.815~0.992).Taking the F3 phase as the demarcation point,the AUC values of the LF Index and the LSM value respectively were 0.886(95% CI:0.826~0.964)and 0.872(95% CI:0.814~0.910).Conclusion Both ultrasound RTE and FS can effectively evaluate the degree of liver fibrosis in patients with chronic hepatitis B.The evaluation of liver fibrosis is equivalent,and the advantages of non-invasive and rapid between two inspection methods.