• Sao Paulo Med J · Nov 2016

    Comparative Study

    Acoustic radiation force impulse (ARFI) elastography compared with biopsy for evaluating hepatic fibrosis after liver transplantation: a cross-sectional diagnostic study.

    • Joel Schmillevitch, Maria Cristina Chammas, Vincenzo Pugliese, Edson Abdala, Adriana Cortez Rizzon, Venâncio Alves, Luiz Augusto Carneiro, and Giovanni Cerri.
    • MD. Researcher, Instituto de Radiologia (InRad), Hospital das Clínicas (HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
    • Sao Paulo Med J. 2016 Nov 1; 134 (6): 513518513-518.

    Context And Objective:Biopsies are used after liver transplantation to evaluate fibrosis. This study aimed to evaluate the elasticity of transplanted livers by means of a non-invasive examination, acoustic radiation force imaging (ARFI) elastography, correlating the results with the histological analysis.Design And Setting:Cross-sectional study in a public university hospital.Methods:All patients consecutively operated between 2002 and 2010 with an indication for biopsy were evaluated by means of elastography. The radiologist evaluating ARFI and the pathologist doing anatomopathological examinations were blinded to each other's evaluations.Results:During the study period, 33 patients were included. The indication for transplantation was cirrhosis due to hepatitis C in 21 cases (63%). Liver biopsies showed absence of fibrosis (F0) in 10 patients, F1 in 11, F2 in 8 and F3 in 4. There were no cases of F4 (cirrhosis). The difference in ARFI values (degree of fibrosis) was 0.26 (95% confidence interval, CI: 0.07-0.52) between the groups F0-F1 and F2-F4 (P = 0.04). An area under the curve of 0.74 (CI: 0.55-0.94) and a cutoff of 1.29 m/s between the groups resulted in the best relationship between sensitivity and specificity. Sensitivity (0.66; CI: 0.50-0.83) was lower than specificity (0.85; CI: 0.72-0.97). There was no significant difference in ARFI between patients with hepatitis C and those with other diseases.Conclusions:The values obtained from elastography were not affected by inflammatory reaction or anatomical alterations. A cutoff point of 1.29 m/s separating patients with or without significant fibrosis was identified.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…