Original Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Apr 14, 2010; 16(14): 1720-1726
Published online Apr 14, 2010. doi: 10.3748/wjg.v16.i14.1720
Real-time sono-elastography in the diagnosis of diffuse liver diseases
Dan Ionuţ Gheonea, Adrian Săftoiu, Tudorel Ciurea, Florin Gorunescu, Sevastiţa Iordache, Gabriel Lucian Popescu, Smaranda Belciug, Marina Gorunescu, Larisa Săndulescu
Dan Ionuţ Gheonea, Adrian Săftoiu, Tudorel Ciurea, Sevastiţa Iordache, Larisa Săndulescu, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Craiova 200349, Romania
Florin Gorunescu, Department of Biostatistics and Informatics, University of Medicine and Pharmacy, Craiova 200349, Romania
Gabriel Lucian Popescu, IT Department, University of Medicine and Pharmacy, Craiova 200349, Romania
Smaranda Belciug, Marina Gorunescu, Faculty of Mathematics of Computer Science, University of Craiova, Craiova 200585, Romania
Author contributions: Gheonea DI and Săftoiu A performed all the recordings of the elastography movies; Ciurea T examined all the patients and collected the clinical data; Iordache S, Săndulescu L and Popescu GL computed and transformed all the elastography recordings into numerical values for statistical analysis; Belciug S, Gorunescu M and Gorunescu F performed the statistical analysis.
Supported by Research Grant, No. 2076/2007, Entitled SONOFIBROCAST, Financed by the Romanian Ministry of Education and Research
Correspondence to: Dan Ionuţ Gheonea, MD, PhD, MSc, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, 1 Mai, 66, Craiova 200639, Romania. digheonea@gmail.com
Telephone: +40-751-268731 Fax: +40-251-310287
Received: September 19, 2009
Revised: December 27, 2009
Accepted: January 3, 2010
Published online: April 14, 2010
Abstract

AIM: To analyze whether computer-enhanced dynamic analysis of elastography movies is able to better characterize and differentiate between different degrees of liver fibrosis.

METHODS: The study design was prospective. A total of 132 consecutive patients with chronic liver diseases and healthy volunteers were examined by transabdominal ultrasound elastography. All examinations were done by two doctors.

RESULTS: Due to the limitations of the method, we obtained high-quality elastography information in only 73.48% of the patients. The κ-means clustering method was applied to assess the inter-observer diagnosis variability, which showed good variability values in accordance with the experience of ultrasound examination of every observer. Cohen’s κ test indicated a moderate agreement between the study observers (κ = 0.4728). Furthermore, we compared the way the two observers clustered the patients, using the test for comparing two proportions (t value, two-sided test). There was no statistically significant difference between the two physicians, regardless of the patients’ real status.

CONCLUSION: Transabdominal real-time elastography is certainly a very useful method in depicting liver hardness, although it is incompletely tested in large multicenter studies.

Keywords: Elastography, Ultrasonography, Liver steatosis, Viral hepatitis, Liver cirrhosis