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Revista chilena de radiología

versión On-line ISSN 0717-9308


CASTRO-SOLARI, Lorena C. et al. Comparison of ARFI hepatic elastography and serologic scores for non-invasive evaluation of hepatic fibrosis in adults with chronic liver disease. Rev. chil. radiol. [online]. 2021, vol.27, n.3, pp.119-126. ISSN 0717-9308.

Non-invasive techniques are useful to quantify the degree of liver fibrosis. Hepatic elastography by ARFI (Acoustic Radiation Force Impulse) has been less studied in our setting.


To describe patients with chronic liver disease (CLD) studied by ARFI, evaluating concordance, advantages or limitations compared with non-invasive biochemical scores (APRI and FIB-4) to graduate liver fibrosis.

Patients and methods:

Retrospective and descriptive study of patients undergoing ARFI between 2013-2019 with a clinical and laboratory history obtained from an electronic medical record. Descriptive statistics and association by c2 were used, with a significance value of p < 0.05.


ARFI was performed 815 times in 731 patients; 488 subjects met inclusion criteria. ARFI was compared between more frequent pathologies. There was a higher frequency of advanced fibrosis (F3 - F4) in Alcoholic Liver Disease (ALD) (42%) and Hepatitis C virus (HCV) (29%) (p < 0.001) and absence or minimal fibrosis (F0-F1) in Non-Alcoholic Fatty Liver Disease (NAFLD) (89%), Hepatitis B Virus (HBV) (77%) and Autoimmune Liver Disease (73%) (p < 0.001). Splenomegaly was associated with F3 - F4 (p < 0.001). Greater liver echogenicity was observed in NAFLD (93%), ALD (84%) and HCV (74%) (p < 0.001). The ARFI, FIB-4 and APRI score tended to increase according to the degree of fibrosis, being concordant in F3-4. When comparing F0-F1 by ARFI with FIB-4 and APRI, there was dispersion of the values in the serological scores.


FIB-4, APRI and ARFI can be helpful in estimating F3-F4, however, they could underestimate or overestimate severity in F0-F1. ARFI would add relevant morphological aspects in CLD.

Palabras clave : Chronic liver disease; Liver fibrosis; ARFI imaging; Elastography; Serologic test.

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