Abstract: Objective To investigate the significance of transient elastography in disease monitoring and treatment evaluation of intrahepatic cholestasis (IHC). Methods A total of 56 IHC patients, who were admitted to our hospital from April 2017 to June 2019, including 21 males and 35 females, aged (38.4±7.5) years, were enrolled. IHC diagnosis conforms to alkaline phosphatase >1.5 times the upper limit of normal value, gamma-glutamyltranspeptidase >3 times the upper limit of normal value, and imaging showing no bile duct dilatation. Measurement data [median (25th percentile, 75th percentile)] were analyzed by Kruskal-Wallis H test, and counting data (%) were analyzed by chi-square test. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency. Results IHC etiology includes 22 cases (39.3%) of autoimmune hepatitis, 12 cases (21.4%) of primary sclerosing cholangitis, 8 cases (14.3%) of drug induction, 6 cases (10.7%) of primary biliary cirrhosis and 8 cases (14.3%) of other causes (overlap syndrome, hepatolenticular degeneration, Budd-Chiari syndrome, EB virus infection and lymphoma). According to METAVIR score, the numbers of IHC patients with fibrosis stage (F) 0, F1, F2, F3 and F4 were 5 cases (8.9%), 9 cases (16.1%), 15 cases (26.8%), 11 cases (19.6%) and 16 cases (28.5%) before treatment, respectively, 14 cases (25.0%), 11 cases (19.6%), 9 cases (16.1%), 6 cases (10.7%) and 16 cases (28.5%) after treatment, respectively (P<0.05). The cut-off value, sensitivity, specificity and area under the ROC curve (AUC) of liver stiffness measurement (LSM) for IHC patients with METAVIR ≥F2 were 6.8 kPa, 98%, 50% and 0.77, respectively. The cut-off value, sensitivity, specificity and AUC for METAVIR ≥F3 were 9.2 kPa, 88%, 83% and 0.90, respectively. The cut-off value, sensitivity, specificity and AUC for F4 were 13.5 kPa, 91%, 98% and 0.93, respectively. The LSM value of IHC patients was [12.8 (9.0, 24.2)] kPa before treatment and [9.6 (5.2, 18.1)] kPa after treatment, with statistical difference (P<0.05). Conclusion Transient elastography is an effective method to evaluate the degree of liver fibrosis, disease severity and therapeutic response in patients with IHC, which has sufficient diagnostic value.

Key words: Intrahepatic cholestasis, Transient elastography, Liver stiffness measurement, Receiver operator characteristic curve