Value of transient elastography combined with portal vein hemodynamics in assessing liver fibrosis in patients with chronic hepatitis B

Abstract

Abstract: Objective To evaluate the value of transient elastography combined with portal vein hemodynamics in assessing liver fibrosis in patients with chronic hepatitis B (CHB). Methods A total of 102 CHB patients were admitted to Shanxi Fenyang Hospital from January 2021 to January 2024. Liver stiffness measurement (LSM) was evalued using transient elastography, while a color Doppler ultrasound diagnostic device was used to measure the portal vein diameter (PVD), maximum flow velocity (Vmax), and mean flow velocity (Vmean). Multivariate logistic regression analysis was conducted to identify the factors influencing the occurrence of liver fibrosis. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of combining transient elastography with portal vein hemodynamics in differentiating liver fibrosis in CHB patients. Results In this study, 102 patients with chronic hepatitis B (CHB) were included. Liver biopsy diagnosed 41 cases (40.20%) with non-significant liver fibrosis and 61 cases (59.80%) with significant liver fibrosis. The LSM of patients with significant liver fibrosis were (13.0±2.6) kPa and (13.6±2.7) mm, respectively, which were higher than those in patients with non-significant fibrosis [(7.1±1.9) kPa and (10.9±2.1) mm]. Additionally, the Vmax and Vmean in significant fibrosis patients were (28.9±3.6) cm/s and (25.3±3.3) cm/s, respectively, which were lower than those in non-significant fibrosis patients [(36.7±4.4) cm/s and (30.9±4.1) cm/s], with statistical significance (P<0.05). Multivariate analysis indicated that patients with higher LSM and PVD, and lower Vmax and Vmean had a higher risk of liver fibrosis (P<0.05). ROC curve analysis showed that the combination of transient elastography and portal vein hemodynamics had a diagnostic accuracy of 0.974 (95% CI: 0.949~0.999), with a sensitivity of 91.8% and specificity of 92.7%. Conclusion The combined application of LSM and portal vein hemodynamics is highly effective in assessing liver fibrosis in patients with CHB, offering superior diagnostic accuracy.

Key words: Transient elastography, Portal vein hemodynamics, Chronic hepatitis B, Liver fibrosis

ZHANG Ying, WANG Xu, CAO Wen-ting, ZHANG Yu-han. Value of transient elastography combined with portal vein hemodynamics in assessing liver fibrosis in patients with chronic hepatitis B[J]. Chinese Hepatolgy, 2025, 30(11): 1511-1514.

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