Transient elastography improves detection of liver cirrhosis compared to routine screening tests |
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Authors: | Thomas G?bel Janine Schadewaldt-Tümmers Lucas Greiner Christopher Poremba Dieter H?ussinger Andreas Erhardt |
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Institution: | Thomas G?bel;Janine Schadewaldt-Tümmers;Lucas Greiner;Christopher Poremba;Dieter H?ussinger;Andreas Erhardt;Klinik für Gastroenterologie,Hepatologie und Infektiologie,Universit?tsklinikum Düsseldorf,40225 Düsseldorf,Germany;Klinik für Gastroenterologie,Hepatologie und Diabetologie,Petrus-Krankenhaus Wuppertal,42283 Wuppertal,Germany;Pathologie München-Nord,Ernst-Platz-Stra?e 2,80992 München,Germany; |
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Abstract: | AIM:To investigate the diagnostic significance oftransient elastography(TE) in a daily routine clinical setting in comparison to clinical signs,laboratory parameters and ultrasound.METHODS:TE,ultrasound,laboratory parameters and cutaneous liver signs were assessed in 291 consecutive patients with chronic liver disease of various aetiologies who underwent liver biopsy in daily routine.RESULTS:Sensitivity of TE for the detection of liver cirrhosis was 90.4%,compared to 80.1% for ultrasound,58.0% for platelet count and 45.1% for cutaneous liver signs(P 0.0001 for comparisons with histology).AUROC for TE was 0.760(95%CI:0.694-0.825).Combination of TE with ultrasound increased sensitivity to 96.1% and AUROC to 0.825(95%CI:0.768-0.882).TE correlated with laboratory parameters of cirrhosis progression like albumin(r =-0.43),prothrombin time(r =-0.44),and bilirubin(r = 0.34; P 0.001 for each).Particularly,in patients with Child Pugh score A or normal platelet count TE improved sensitivity for the detection of liver cirrhosis compared to ultrasound by 14.1%(P 0.04) and 16.3%(P 0.02),respectively.CONCLUSION:Transient elastography is superior to routine diagnostic tests allowing detection of liver cirrhosis in additional 10%-16% of patients with chronic liver disease that would have been missed by clinical examinations. |
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Keywords: | Transient elastography Fibroscan Liver cirrhosis Liver disease Chronic hepatitis |
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