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Revista chilena de radiología

versión On-line ISSN 0717-9308

Resumen

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.  http://dx.doi.org/10.24875/rchrad.m21000001.

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.

Objective:

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.

Results:

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.

Conclusion:

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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