关键词: 超声弹性成像, 肝纤维化, 慢性乙型肝炎

Abstract: Objective To assess liver fibrosis in patients with chronic hepatitis B (CHB) by liver and spleen stiffness measurement based on ultrasonic elastography (UE), and serum liver fibrosis indexes (APRI, FIB-4, and King′s score).Methods A total of 98 CHB patients were selected as the research subjects from October 2018 to August 2021. The participants included 51 males and 47 females, with an age of (35.3±7.8) years. UE was used to measure liver hardness (LSM) and spleen hardness (SSM) in each patient. Additionally, all patients underwent ultrasound-guided liver biopsy after the UE examination. Results The success rate of UE measurement was 100%, and the data was reliable. The AST, LSM and SSM of male were (86.0±23.1) U/L, (10.6±3.4) kPa and (18.1±4.7) kPa, which were significantly higher than those of female [(71.4±19.3) U/L, (8.7±2.7) kPa and (15.5±5.4) kPa, P<0.05]. The age and GGT of males were (34.7±6.4) years and (70.6±29.3) U/L, respectively, which were significantly different from those of females ((37.0±6.8) years and (88.2±34.5) U/L) (P<0.05). With the increase of liver fibrosis, LSM, SSM, APRI, FIB-4 and King′s scores increased significantly (P<0.05). The AUC values of LSM and SSM were significantly higher compared to APRI, FIB-4 and King′s scores (P<0.05) when evaluating ≥S2 hepatic fibrosis. The AUC, cut-off point, sensitivity and specificity of LSM in diagnosing ≥S2 hepatic fibrosis were 0.82, 7.8 kPa, 77.4% and 92.5%, respectively. The AUC, cut-off point, sensitivity and specificity of SSM in diagnosis of ≥S2 hepatic fibrosis were 0.85, 8.7 kPa, 80.6% and 94.0%, respectively. Conclusion Compared to APRI, FIB-4, and King′s scores, LSM and SSM detected by UE exhibit superior diagnostic efficiency for CHB liver fibrosis staging.

Key words: Ultrasonic elastography, Liver fibrosis, Chronic hepatitis B