Revista argentina de radiología
On-line version ISSN 1852-9992
KUCHARCZYK, Mariana et al. Noninvasive measurement of hepatic fibrosis: elastography. Experience in 1200 tests. Rev. argent. radiol. [online]. 2012, vol.76, n.3, pp. 221-227. ISSN 1852-9992.
Purpose. To report our experience from 1200 transient elastographies and correlate results with different etiologies and liver biopsy. Materials and Methods. We performed a retrospective study of patients undergoing transient elastography (TE) between 08/2009 and 04/2011. A database was completed considering clinical and histological data. Body mass index (BMI) was calculated in all cases. Tests were considered valid if the success rate was > 60% and the interquartile range (IQR) was < 30%. We assessed the degree of agreement between TE and histology. We compared biopsy number and sampling with a previous period. Results. One thousand-two hundred tests were evaluated. Etiologies: hepatitis C virus (HCV) infection 40%, non-alcoholic fatty liver disease (NAFLD) 20.8%, hepatitis B virus (HBV) infection 10.7%, cholestasis 9.1%, others 19.4%. Significant fibrosis (F > 2) was detected in 32.3% of HCV, 32.1% of HBV, 31.5% of NAFLD and 33.4% of cholestasis. In 154 of 1200 patients we found BMI > 28 kg/m2, however, the test was valid in 121 patients. In 34 patients, no valid results could be achieved because of BMI > 28 kg/m2 and fatty thoracic belt > 2.5 cm in 33 of them. Simultaneous biopsy (within 6 months) was performed in 388 patients, with an overall agreement of 77%. We found a 30% decrease in diffuse liver biopsies in HCV patients when comparing the period 01/2008 - 08/2009 with 09/2009 - 04/2011. In HCV patients who underwent liver transplantation (n=21) agreement was 90.4%; 100% with gradient measurement and TE. Conclusion. We obtained similar results to those reported in the literature. We found an excellent correlation with biopsy in HCV transplanted patients. The main limitation was the fatty thoracic belt > 2.5 cm. The growing number of TE studies and decreased diffuse liver biopsies reflect the progressive incorporation of elastography into the diagnostic algorithm of chronic liver diseases.
Keywords : Elastography; Liver fibrosis.