Document Detail


Performance of unidimensional transient elastography in staging non-alcoholic steatohepatitis.
MedLine Citation:
PMID:  20361076     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Transient elastography (TE) is a noninvasive method for predicting liver fibrosis, mainly validated in patients with viral hepatitis. Information is still limited concerning its performance in non-alcoholic steatohepatitis (NASH) patients. We aimed to assess the value of TE in the prediction of fibrosis stage in NASH as well as the factors determining the discordance between the TE-predicted and the biopsy-proven fibrosis stage in these patients. METHODS: Liver biopsy and TE were performed on 72 consecutive NASH patients. Fibrosis, lobular inflammation, ballooning and steatosis were evaluated (Brunt system). RESULTS: Liver stiffness (LS) values ranged from 2.80 to 16.90 kPa. In the univariate analysis, LS was correlated with fibrosis (r=0.661; p<0.0001), steatosis (r=0.435, p<0.0001), ballooning (r=0.385; p=0.001) and lobular inflammation (r=0.364; p=0.002). In multivariate analysis, only fibrosis significantly correlated with LS (p<0.0001). The median (and range) LS values (kPa) according to the fibrosis stages were: 4.90 (2.80-7.30) for F0; 6.15 (4.80-12.50) for F1; 6.90 (3.30-16.90) for F2 and 14.00 (10.70-14.10) for F3, with significant difference between stages, except for F1-F2 (p=0.249). Cut off values were calculated for predicting each fibrosis stage: 5.3 kPa (AUROC=0.879) for F1; 6.8 kPa (AUROC=0.789) for F2; and 10.4 kPa (AUROC=0.978) for F3. Patients with false-positive results had a significantly higher ALT level than those with concordant results (p=0.039). CONCLUSION: In NASH patients, TE allows a reliable assessment and prediction of liver fibrosis, especially in advanced stages. Steatosis, ballooning and inflammation do not influence liver stiffness.
Authors:
Monica Lupsor; Radu Badea; Horia Stefanescu; Mircea Grigorescu; Alexandru Serban; Corina Radu; Dana Crişan; Zeno Sparchez; Sorana Iancu; Anca Maniu
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of gastrointestinal and liver diseases : JGLD     Volume:  19     ISSN:  1841-8724     ISO Abbreviation:  J Gastrointestin Liver Dis     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-04-02     Completed Date:  2010-09-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101272825     Medline TA:  J Gastrointestin Liver Dis     Country:  Romania    
Other Details:
Languages:  eng     Pagination:  53-60     Citation Subset:  IM    
Affiliation:
Department of Medical Imaging, 3rd Medical Clinic, University of Medicine and Pharmacy, 19-21 Croitorilor Street, 400162 Cluj-Napoca, Romania. monica.lupsor@umfcluj.ro
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biopsy, Needle
Elasticity Imaging Techniques*
Fatty Liver / complications,  pathology,  ultrasonography*
Female
Humans
Liver / pathology,  ultrasonography*
Liver Cirrhosis / etiology,  pathology,  ultrasonography*
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
ROC Curve
Reproducibility of Results
Sensitivity and Specificity
Severity of Illness Index
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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