Comparison of diagnostic accuracy of magnetic resonance elastography and Fibroscan for detecting liver fibrosis in chronic hepatitis B patients: A systematic review and meta-analysis

Gd-EOB-DTPA DCE-MRI biomarkers in a rabbit model of liver fibrosis

The purpose of this study was to investigate the correlations between Gd-EOB-DTPA DCE-MRI biomarkers and histopathologic biomarkers of liver fibrosis progression in a rabbit model of liver fibrosis. Thirty-Six New Zealand white rabbits were randomly divided into control (n = 6) and liver fibrosis group (n = 30). Each rabbit in the liver fibrosis group received a weekly subcutaneous injection in the back comprising 50% carbon tetrachloride (CCl₄) in oily solution. Control rabbits received subcutaneous injections with the same amount of normal saline solution instead. MR imaging was performed in control and fibrotic rabbits were conducted by MRI at week 0 (n = 36). The fibrotic rabbits were performed MR imaging on 6 weeks, 9 weeks, and 12 weeks after modeling of fibrosis. Before each MRI, peripheral blood was collected, and several biochemical testes are performed. The thirty-four rabbits completed this study. They were then divided into three subgroups according to fibrotic stage: no fibrosis (F0, n = 12), mild fibrosis (F1+F2, n = 14), and advanced fibrosis (F3+F4, n = 8). DCE-MRI measurements show increasing K^trans and V_e while decreasing iACU90 with increasing fibrosis stage. The significant correlations were observed between mean K^trans, V_e, iACU90 and percentage of the animal with mild liver fibrosis. For blood biomarkers, there were significant differences between F0 and F1+F2, and between F0 and F3+F4 in the serum levels of ALT (all P < 0.05), and TB (F0 vs. F1+F2, P = 0.004), while no differences were found between F1+F2 group and F3+F4 group (all P > 0.05). There were significant differences between F0 and F1+F2 (P = 0.02). Gd-EOB-DTPA DCE-MRI is a promising method for the noninvasive diagnosis and staging of liver fibrosis. Future studies to evaluate the effectiveness of these techniques in patients with liver fibrosis are warranted.

Value of real-time shear wave elastography in assessing liver fibrosis in patients with chronic hepatitis B

AIM

To evaluate the value of real-time shear wave elastography (SWE) and routine ultrasonography in the assessment of liver fibrosis in patients with chronic hepatitis B.

METHODS

A retrospective analysis was performed of 87 patients with chronic hepatitis B treated in Tangshan Infectious Disease Hospital from August 2015 to June 2017. All patients underwent routine ultrasound and SWE examinations. Using the pathological biopsy results as the gold standard, the results of routine ultrasound and SWE in staging and diagnosing liver fibrosis were compared by ROC curve analysis.

RESULTS

There was no significant difference in conventional ultrasound scores between adjacent stages of liver fibrosis (S0-S1 vs S2, S2 vs S3, and S3 vs S4), but there were significant differences between non-adjacent stages (S0-S1 vs S3, S0-S1 vs S4, and S2 vs S4; P = 0.001, 0.000, and 0.000, respectively). The elastic modulus values of SWE in different stages of liver fibrosis were 5.625 kPa ± 1.221 kPa (S0), 7.172 kPa ± 1.818 kPa (S1), 10.295 kPa ± 3.122 kPa (S2), 15.541 kPa ± 4.340 kPa (S3), and 23.918 kPa ± 5.697 kPa (S4). There was a significant difference in the elastic modulus values between both adjacent and non-adjacent stages (P < 0.05 for all). Spearman correlation analysis showed that there was a positive correlation between conventional ultrasound score or SWE elastic modulus and liver fibrosis stage (r = 0.529, 0.798, P < 0.001). The areas under the ROC curve of conventional ultrasound score in diagnosing liver fibrosis S ≥ 2, S ≥ 3, and S4 were 0.766, 0.891, and 0.764, respectively; the corresponding values of SWE were 0.941, 0.948, and 0.952, respectively. The diagnostic efficiency of SWE was higher than that of conventional ultrasound (P < 0.05).

CONCLUSION

Compared with conventional ultrasound, SWE has higher value in assessing the degree of liver fibrosis in patients with chronic hepatitis B, with better reproducibility.