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Application of acoustic radiation force impulse elastography combined with serum markers in Child-Pugh grading

OBJECTIVES: Acoustic radiation force impulse (ARFI) elastography, the aspartate aminotransferase-to-alanine aminotransferase ratio (AAR), aspartate aminotransferase-to-platelet ratio index (APRI), and the fibrosis-4 (FIB-4) index are widely used to assess liver fibrosis. However, efficacies of these...

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Autores principales: Wei, Linglin, Ye, Zhen, Bao, Zhongtao, Xu, Xiang, Lin, Xiaoyu, Chen, Ling
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Faculdade de Medicina / USP 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7470432/
https://www.ncbi.nlm.nih.gov/pubmed/32935822
http://dx.doi.org/10.6061/clinics/2020/e1670
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author Wei, Linglin
Ye, Zhen
Bao, Zhongtao
Xu, Xiang
Lin, Xiaoyu
Chen, Ling
author_facet Wei, Linglin
Ye, Zhen
Bao, Zhongtao
Xu, Xiang
Lin, Xiaoyu
Chen, Ling
author_sort Wei, Linglin
collection PubMed
description OBJECTIVES: Acoustic radiation force impulse (ARFI) elastography, the aspartate aminotransferase-to-alanine aminotransferase ratio (AAR), aspartate aminotransferase-to-platelet ratio index (APRI), and the fibrosis-4 (FIB-4) index are widely used to assess liver fibrosis. However, efficacies of these methods in the evaluation of hepatic functional reserve remain unclear. In this study, we investigated the relationship between ARFI elastography combined with either AAR, APRI, or FIB-4 index and Child-Pugh (CP) class for the evaluation of hepatic functional reserve in patients with chronic hepatitis B (CHB)-related cirrhosis. METHODS: The shear wave velocities of 104 patients with clinically confirmed CHB-related cirrhosis were determined using the ARFI; and clinical serum markers (e.g. ALT, AST, PLT) were used to calculate the AAR, APRI, and FIB-4 index. Cirrhosis patients were scored according to their CP class. The ARFI, AAR, APRI, and FIB-4 index were compared with the CP class. The efficacy of each indicator in diagnosis was analyzed using the receiver operating characteristic (ROC) curve and the ARFI combined with either the AAR, APRI, or FIB-4 index, which is used to predict decompensated cirrhosis. RESULTS: No significant differences were observed in gender and age among CP classes A, B, and C patients (p>0.05). The ARFI values and the AAR, APRI, and FIB-4 index of patients with CP classes A, B, and C were significantly different (p<0.05). With an increasing CP class, the ARFI, AAR, APRI, and FIB-4 values increased. The correlation between the ARFI and the CP class was stronger than that between the AAR, APRI, and FIB-4 index and the CP class. The area under the ROC curve for the diagnosis of decompensated cirrhosis using the ARFI was 0.841, which was higher than that for the AAR, APRI, and FIB-4 index. According to the area under the curve results, no significant differences were found when the ARFI was combined with either the AAR, APRI, or FIB-4 index and when the ARFI alone was used. CONCLUSIONS: The ARFI value has a strong correlation with the CP class. Therefore, ARFI elastography complements CP class in the assessment of the hepatic functional reserve in patients with CHB-related cirrhosis.
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spelling pubmed-74704322020-09-16 Application of acoustic radiation force impulse elastography combined with serum markers in Child-Pugh grading Wei, Linglin Ye, Zhen Bao, Zhongtao Xu, Xiang Lin, Xiaoyu Chen, Ling Clinics (Sao Paulo) Original Article OBJECTIVES: Acoustic radiation force impulse (ARFI) elastography, the aspartate aminotransferase-to-alanine aminotransferase ratio (AAR), aspartate aminotransferase-to-platelet ratio index (APRI), and the fibrosis-4 (FIB-4) index are widely used to assess liver fibrosis. However, efficacies of these methods in the evaluation of hepatic functional reserve remain unclear. In this study, we investigated the relationship between ARFI elastography combined with either AAR, APRI, or FIB-4 index and Child-Pugh (CP) class for the evaluation of hepatic functional reserve in patients with chronic hepatitis B (CHB)-related cirrhosis. METHODS: The shear wave velocities of 104 patients with clinically confirmed CHB-related cirrhosis were determined using the ARFI; and clinical serum markers (e.g. ALT, AST, PLT) were used to calculate the AAR, APRI, and FIB-4 index. Cirrhosis patients were scored according to their CP class. The ARFI, AAR, APRI, and FIB-4 index were compared with the CP class. The efficacy of each indicator in diagnosis was analyzed using the receiver operating characteristic (ROC) curve and the ARFI combined with either the AAR, APRI, or FIB-4 index, which is used to predict decompensated cirrhosis. RESULTS: No significant differences were observed in gender and age among CP classes A, B, and C patients (p>0.05). The ARFI values and the AAR, APRI, and FIB-4 index of patients with CP classes A, B, and C were significantly different (p<0.05). With an increasing CP class, the ARFI, AAR, APRI, and FIB-4 values increased. The correlation between the ARFI and the CP class was stronger than that between the AAR, APRI, and FIB-4 index and the CP class. The area under the ROC curve for the diagnosis of decompensated cirrhosis using the ARFI was 0.841, which was higher than that for the AAR, APRI, and FIB-4 index. According to the area under the curve results, no significant differences were found when the ARFI was combined with either the AAR, APRI, or FIB-4 index and when the ARFI alone was used. CONCLUSIONS: The ARFI value has a strong correlation with the CP class. Therefore, ARFI elastography complements CP class in the assessment of the hepatic functional reserve in patients with CHB-related cirrhosis. Faculdade de Medicina / USP 2020-09-03 2020 /pmc/articles/PMC7470432/ /pubmed/32935822 http://dx.doi.org/10.6061/clinics/2020/e1670 Text en Copyright © 2020 CLINICS http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.
spellingShingle Original Article
Wei, Linglin
Ye, Zhen
Bao, Zhongtao
Xu, Xiang
Lin, Xiaoyu
Chen, Ling
Application of acoustic radiation force impulse elastography combined with serum markers in Child-Pugh grading
title Application of acoustic radiation force impulse elastography combined with serum markers in Child-Pugh grading
title_full Application of acoustic radiation force impulse elastography combined with serum markers in Child-Pugh grading
title_fullStr Application of acoustic radiation force impulse elastography combined with serum markers in Child-Pugh grading
title_full_unstemmed Application of acoustic radiation force impulse elastography combined with serum markers in Child-Pugh grading
title_short Application of acoustic radiation force impulse elastography combined with serum markers in Child-Pugh grading
title_sort application of acoustic radiation force impulse elastography combined with serum markers in child-pugh grading
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7470432/
https://www.ncbi.nlm.nih.gov/pubmed/32935822
http://dx.doi.org/10.6061/clinics/2020/e1670
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