Liver stiffness measurements by 2-dimensional shear wave elastography compared to histological and ultrasound parameters in primary biliary cholangitis
Liver stiffness measurements (LSMs) by 2-dimensional-shear-wave elastography (LSM 2D-SWE ) are now widely used in hepatology. However, relevant information for primary biliary cholangitis (PBC) is scant. We compare LSM 2D-SWE with liver biopsy (LB) in a cohort of PBC patients in Greece. Data of 68 L...
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| Published in: | Scandinavian journal of gastroenterology Vol. 56; no. 10; pp. 1187 - 1193 |
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| Main Authors: | , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Taylor & Francis
03-10-2021
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Liver stiffness measurements (LSMs) by 2-dimensional-shear-wave elastography (LSM
2D-SWE
) are now widely used in hepatology. However, relevant information for primary biliary cholangitis (PBC) is scant. We compare LSM
2D-SWE
with liver biopsy (LB) in a cohort of PBC patients in Greece.
Data of 68 LBs from 53 PBC patients were retrospectively analyzed and fibrosis stage was compared to LSM
2D-SWE
. Forty-six patients (86.8%) were females and at the time of LBx median (IQR) age was 62.6 (53.2-72.1). Demographic, UDCA treatment, histological and B-mode ultrasound data were tested for their influence on LSM
2D-SWE
estimates.
Liver fibrosis stages F0-F4 were found in 4, 19, 19, 16 and 10 cases, respectively. Across stages F0-F4, the LSM
2D-SWE
was 5.6 (5.1-6.1), 7.0 (5.8-7.7), 9.1 (7.3-11.5), 10.8 (9.9-12.2) and 14.5 (11.9-25.7) kPa, respectively, with highly significant difference (p<.001). The LSM
2D-SWE
differed also significantly between F0 vs. F1 (p=.027), F1 vs. F2 (p=.005) and F3 vs. F4 (p=.017). The discriminatory ability of LSM
2D-SWE
for mild, significant, severe fibrosis and cirrhosis was highly significant in all comparisons (p<.001), with AUC
2D-SWE
95.3%, 87.4%, 85.3% and 95.3% and accuracy 89.7%, 85.3%, 80.9% and 86.8%, respectively. Among 21 parameters tested, significant predictors of LSM
2D-SWE
by multiple linear regression were fibrosis stage, portal inflammation and parenchymal heterogeneity. The portal inflammation grade accounted for 32.2% of LSM variation with adjusted R
2
0.428.
In patients with PBC, LSM measurements by 2D-SWE can reliably discriminate between mild, significant, severe fibrosis and cirrhosis. Measurements are significantly affected by portal inflammation grade. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 0036-5521 1502-7708 |
| DOI: | 10.1080/00365521.2021.1928277 |