Clinical value of liver stiffness value detected by FibroTouch combined with portal vein hemodynamics in evaluating liver fibrosis in patients with chronic hepatitis B

Abstract

Abstract: Objective To explore the evaluation value of liver stiffness value (LSM) combined with the portal vein hemodynamic indicators detected by Doppler ultrasound for liver fibrosis in patients with chronic hepatitis B (CHB). Methods Between August 2020 and July 2023, 99 CHB patients admitted to our hospital underwent liver biopsy, instantaneous elastography, and Doppler ultrasound examination. Their liver fibrosis status, LSM, portal vein main diameter (PVD), resting portal vein maximum flow velocity (Vmax), and mean flow velocity (Vmean) were recorded. According to the Metavir fibrosis scoring system of patients, they were divided into three groups: without liver fibrosis (F0 stage), mild liver fibrosis group (F1-F2 stage) and significant liver fibrosis group (≥ F3 stage). The LSM, PVD, Vmax, and Vmean of the three groups were compared. Spearman correlation analysis was used to analyze the correlation among the LSM, PVD, Vmax, Vmean and Metavir score. Receiver operating curve (ROC) analysis was used to evaluate the value of LSM, PVD, Vmax, and Vmean in evaluating liver fibrosis in CHB patients. Results Pathological biopsy showed that among the 99 patients, there were 16 cases in F0 stage, 30 cases in F1 stage, 24 cases in F2 stage, 20 cases in F3 stage, and 9 cases in F4 stage. LSM and PVD: significant hepatic fibrosis group [(13.67±1.95) kPa, (13.35±1.32) mm] > mild hepatic fibrosis group [(6.81±0.97) kPa, (11.77±1.15) mm] > no hepatic fibrosis group [(5.12±0.84) kPa、(10.84±1.04) mm]. Vmax, Vmean: significant hepatic fibrosis group [(29.04±2.11) cm/s, (24.58±1.93) cm/s] < mild hepatic fibrosis group [(33.26±2.04) cm/s, (27.10±1.86) cm/s]. LSM, PVD and Metavir score in CHB patients were significantly positively correlated (r=0.649, r=0.477, P<0.05), while Vmax and Vmean were significantly negatively correlated with Metavir score (r=-0.561, r=-0.538, P<0.05). The area under the curve (AUC) of LSM, PVD, Vmax, Vmean, and their combined detection for evaluating significant liver fibrosis in CHB patients were 0.938, 0.886, 0.800, 0.867, and 0.983, respectively, with sensitivities of 82.76%, 89.66%, 82.76%, 79.31%, and 96.55%, and specificity of 91.43%, 80.00%, 64.29%, 77.14%, and 90.00%. The combined detection had a better evaluation efficacy for significant liver fibrosis in CHB patients than the individual detection of each indicator (P<0.05). Conclusion LSM and portal vein hemodynamic indicators are related to the liver fibrosis in CHB patients. The combination of LSM and Doppler ultrasound detection of portal vein hemodynamic indicators has a good evaluation efficacy for liver fibrosis in CHB patients.

Key words: Chronic hepatitis B, Doppler ultrasound, Portal venous hemodynamics, Liver hardness value, Hepatic fibrosis

DANG Miao-miao, DU Miao-miao, GAO Yan-mei. Clinical value of liver stiffness value detected by FibroTouch combined with portal vein hemodynamics in evaluating liver fibrosis in patients with chronic hepatitis B[J]. Chinese Hepatolgy, 2024, 29(10): 1230-1234.

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