ARFI, FibroScan (R), ELF, and their combinations in the assessment of liver fibrosis: A prospective study

作者：Crespo Gonzalo; Fernandez Varo Guillermo; Marino Zoe; Casals Gregori; Miquel Rosa; Martinez Stella M; Gilabert Rosa; Forns Xavier; Jimenez Wladimiro; Navasa Miquel^*

来源：Journal of Hepatology, 2012, 57(2): 281-287.

DOI：10.1016/j.jhep.2012.03.016

• Acoustic radiation force impulse
• Transient elastography
• Enhanced liver fibrosis
• Liver transplantation

Background %26 Aims: Our aim was to evaluate a serologic marker (ELF) and two ultrasound-based methods (FibroScan (R) and ARFI), as well as their combinations, in the assessment of liver fibrosis. %26lt;br%26gt;Methods: One-hundred and forty-six patients (87 liver transplant recipients, 59 non-transplant patients) who underwent liver biopsy were prospectively included. We evaluated the diagnostic accuracy of FibroScan (R), ARFI, ELF and the combination of ELF with either ARFI or FibroScan (R). After analyzing in separate transplant and non-transplant patients, the whole cohort was divided into a training set and a validation set. %26lt;br%26gt;Results: ARFI imaging was successfully performed across the whole cohort, while FibroScan (R) failed in 16 (11%) patients. The three methods showed similar AUROCs and best cut-off values in transplant and non-transplant patients. In the training set, differences between the AUROCs of ARFI, FibroScan (R) and ELF to diagnose F %26gt;= 2 (0.879, 0.861, and 0.764, respectively) and cirrhosis (0.936, 0,918, and 0.841) were not statistically significant, although both ultrasound-based methods showed higher accuracy than ELF. The combination of ELF with ARFI or FibroScan increased the negative and positive predictive values of single tests for the diagnosis of F %26gt;= 2 and cirrhosis. Similar results were obtained when the methods were tested in the validation set. %26lt;br%26gt;Conclusions: ARFI is as effective as either FibroScan (R) or ELF in the non-invasive assessment of liver fibrosis, and its inclusion in an ultrasound device could facilitate its incorporation into routine clinical practice. The combination of ARFI or FibroScan (R) with ELF may help better identify patients with or without significant fibrosis or cirrhosis.

• 出版日期2012-8