Evidence-Based Medicine
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2014; 20(28): 9528-9533
Published online Jul 28, 2014. doi: 10.3748/wjg.v20.i28.9528
Liver fibrosis evaluation by ARFI and APRI in chronic hepatitis C
Su-Mei Li, Guang-Xia Li, Dong-Mei Fu, Yu Wang, Li-Qun Dang
Su-Mei Li, Guang-Xia Li, Dong-Mei Fu, Yu Wang, Li-Qun Dang, Department of Physical Diagnosis B Ultrasound Room, Daqing Longnan Hospital, Qiqihar Medical College Affiliated Fifth Hospital, Daqing 163453, Heilongjiang Province, China
Author contributions: Li SM, Li GX, Fu DM and Wang Y collected and analyzed the data; Li SM wrote the manuscript; Dang LQ performed the statistical analysis; Li SM had overall responsibility for the scientific content of the manuscript; all authors jointly conceived the idea of the manuscript, as well as, contributing to the analysis, review, and editing of the content.
Correspondence to: Su-Mei Li, Associate Chief Physician, Department of Physical Diagnosis B Ultrasound Room, Daqing Longnan Hospital, Qiqihar Medical College Affiliated Fifth Hospital, No. 35 AiGuo Road, Daqing 163453, Heilongjiang Province, China. lisumei626@sina.com
Telephone: +86-459-5910872 Fax: +86-459-5910872
Received: January 29, 2014
Revised: April 9, 2014
Accepted: April 30, 2014
Published online: July 28, 2014
Abstract

AIM: To explore the value of liver fibrosis assessment by acoustic radiation force impulse (ARFI) and the AST/PLT ratio index (APRI) in chronic hepatitis C patients.

METHODS: One hundred and twenty eight patients with chronic hepatitis C were examined using ARFI elastometry and APRI, calculated according to known formulae. The gold standard of liver biopsy was referred; ROC curve analysis was used to assess all ARFI and APRI values. The corresponding cut-off values, sensitivities, and specificities were calculated and compared. In addition, the correlation of liver fibrosis stages in chronic hepatitis C patients with ARFI measurements and APRI were also tested to evaluate significant data.

RESULTS: The values of ARFI in S1-S4 were 1.23 ± 0.34 m/s, 1.48 ± 0.43 m/s, 2.06 ± 0.45 m/s, and 2.30 ± 0.87 m/s. The values of APRI in S1-S4 were 0.31 ± 0.45 m/s, 0.28 ± 0.38 m/s, 0.58 ± 0.59 m/s and 0.65 ± 0.34 m/s. ARFI (r = 0.649, P < 0.05) showed a better correlation with liver fibrosis stages in chronic hepatitis C than APRI (r = 0.478, P < 0.05). The areas under the ROC curves for ARFI and APRI were 0.775 and 0.721 for stages ≥ S2, 0.901 and 0.787 for stages ≥ S3, and 0.792 and 0.780 for S = 4, respectively.

CONCLUSION: Both ARFI and APRI could evaluate liver fibrosis stages in chronic hepatitis C. ARFI is more accurate than the APRI index.

Keywords: Liver fibrosis, Chronic hepatitis C, Acoustic radiation force impulse, AST/PLT ratio index, Sensitivity, Specificity

Core tip: This study has utilized acoustic radiation force impulse (ARFI) technology and the AST/PLT ratio index (APRI) model to detect and analyze the degree of liver fibrosis in 128 patients with hepatitis C. The clinical value and accuracy of these two methods were explored in the evaluation of liver fibrosis stages of patients with chronic hepatitis C. ARFI could more accurately evaluate liver fibrosis in patients with chronic hepatitis C than the APRI.