Dynamic evaluation of liver stiffness measurement to improve diagnostic accuracy of liver cirrhosis in patients with chronic hepatitis B acute exacerbation |
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Authors: | Liang X-E Chen Y-P Zhang Q Dai L Zhu Y-F Hou J-L |
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Affiliation: | Hepatology Unit and Department of Infectious Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China. |
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Abstract: | Summary. To investigate the dynamic changes of liver stiffness measurement (LSM) by FibroScan® and improve its diagnostic accuracy, we studied patients with chronic hepatitis B undergoing acute exacerbation. Eighty‐nine treatment naïve patients were enrolled, and Fibroscan® was performed every 7–10 days during hospitalization and every 1~3 months for follow‐up. Haematology and liver functions were tested in parallel. Liver biopsies were performed in 23 patients. A total of 282 LSMs were performed. LSM was positively correlated with both alanine aminotransferase (ALT) (r = 0.321, P < 0.001) and bilirubin levels (r = 0.626, P < 0.001). Mean reduction in LSMs in patients along with ALT or bilirubin normalization was significantly greater than those without ALT or bilirubin nomalization(P = 0.001, P = 0.038, respectively). In 23 patients with initial LSMs in the range usually defined as indicating cirrhosis (i.e.>18.2 kPa), only 5 were diagnosed with cirrhosis by histopathology or ultrasonography. As ALT normalized, LSMs remained over 12.0 kPa in all these 5 patients. However, in 18 other patients without cirrhosis at baseline, LSMs still remained above 12.0kPa in 10 patients and decreased to below 12.0 kPa in the other 8 patients. LSMs decreased in parallel with ALT and bilirubin normalization. LSM performed after ALT and bilirubin nomalization may improve the accuracy in diagnosing cirrhosis in patients with exacerbations of hepatitis B. |
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Keywords: | alanine aminotransferase bilirubin chronic hepatitis B liver stiffness measurement |
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