New Noninvasive Assessment of Liver Fibrosis in Chronic Hepatitis B

liver411

<http://www.jultrasoundmed.org/cgi/content/abstract/29/8/1213>

© 2010 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 29:1213-1221 • 0278-4297
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Technical Advance
New Noninvasive Assessment of Liver Fibrosis in Chronic Hepatitis B
Maximal Accumulative Respiration Strain

Xiangdong Hu, MD, Jinhua Shao, PhD, Jing Bai, PhD, Jinrui Wang, MD and Linxue
Qian, MD

Department of Ultrasound, Beijing Friendship Hospital, Capital Medical
University, Beijing, China (X.H., L.Q.); Department of Biomedical Engineering,
School of Medicine, Tsinghua University, Beijing, China (J.S., J.B.); and
Department of Ultrasound, Peking University Third Hospital, Beijing, China
(J.W.).

Address correspondence to Linxue Qian, MD, Department of Ultrasound, Beijing
Friendship Hospital, Capital Medical University, 100050 Beijing, China.
E-mail: [email protected];

Objective. A novel parameter acquired from conventional B-mode sonographic
videos was introduced in this study, and its diagnostic accuracy for
evaluation of hepatic fibrosis was investigated. Methods. Twenty-eight
patients with chronic hepatitis B and 8 patients with hepatic cysts in the
right lobe (controls) were enrolled. B-mode sonographic videos of hepatic
motion under the ensisternum in the sagittal plane were captured during
peaceful breathing. Maximal accumulative respiration strain (MARS) values of
hepatic tissue were obtained after image analysis. METAVIR scoring after liver
biopsy was considered the standard. First, the relationship between MARS and
the fibrotic stage was studied; and second, receiver operating characteristic
(ROC) curves were used to assess the accuracy of MARS for evaluation of the
fibrotic stage. Results. When the transducer was placed in the sagittal
imaging plane under the ensisternum during the whole respiratory period, the
hepatic tissue motion was almost in the same plane. The MARS values (mean ±
SD) were 29.44% ± 10.44% in the F0 group (no fibrosis; n = 8), 19.30% ±
9.10% in the F1 group (portal fibrosis without septa; n = 8), 18.09% ± 7.36%
in the F2–F3 group (portal fibrosis with few septa or numerous septa without
cirrhosis; n = 12), and 14.16% ± 4.18% in the F4 group (cirrhosis; n = 8).
The Spearman correlation coefficient between MARS and the fibrotic stage was
0.516 (P = .001). The diagnostic accuracy rates, expressed as areas under the
ROC curves, were 0.87 for mild fibrosis (F  1), 0.72 for substantial fibrosis
(F  2), and 0.75 for cirrhosis (F = 4). Conclusions. Maximal accumulative
respiration strain attained from B-mode sonographic videos of hepatic tissue
is a new, convenient, economical, and promising noninvasive parameter for
assessment of hepatic fibrosis in patients with chronic hepatitis B.