Doppler ultrasonography combined with transient elastography improves the non-invasive assessment of fibrosis in patients with chronic liver diseases.

Aims: Accurate clinical assessment of liver fibrosis is essential and the aim of our study was to compare and combine hemodynamic Doppler ultrasonography, liver stiffness by transient elastography, and non-invasive serum biomarkers with the degree of fibrosis confirmed by liver biopsy, and thereby t...

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Publicado en:Medical Ultrasonography Vol. 19; no. 1; pp. 7 - 16
Autores principales: Alempijevic, Tamara, Zec, Simon, Nikolic, Vladimir, Veljkovic, Aleksandar, Stojanovic, Zoran, Matovic, Vera, Milosavljevic, Tomica
Formato: research tables/charts Journal Article
Publicado: Romanian Society of Ultrasonography in Medicine & Biology Mar2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2017
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      pub: Romanian Society of Ultrasonography in Medicine & Biology
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        atl: Doppler ultrasonography combined with transient elastography improves the non-invasive assessment of fibrosis in patients with chronic liver diseases.
      aug:
        au:
          Alempijevic, Tamara
          Zec, Simon
          Nikolic, Vladimir
          Veljkovic, Aleksandar
          Stojanovic, Zoran
          Matovic, Vera
          Milosavljevic, Tomica
        affil: School of Medicine, University of Belgrade
      sug:
        subj:
          Liver Cirrhosis
          Ultrasonography
          Ultrasonography, Doppler
          Liver
          Liver Cirrhosis Blood
          Reproducibility of Results
          Aged
          Adult
          Liver Diseases
          Sensitivity and Specificity
          Male
          Young Adult
          ROC Curve
          Female
          Chronic Disease
          Middle Age
          Liver Diseases Blood
          Human
          Aged: 65+ years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Aims: Accurate clinical assessment of liver fibrosis is essential and the aim of our study was to compare and combine hemodynamic Doppler ultrasonography, liver stiffness by transient elastography, and non-invasive serum biomarkers with the degree of fibrosis confirmed by liver biopsy, and thereby to determine the value of combining non-invasive method in the prediction significant liver fibrosis.Material and Methods: We included 102 patients with chronic liver disease of various etiology. Each patient was evaluated using Doppler ultrasonography measurements of the velocity and flow pattern at portal trunk, hepatic and splenic artery, serum fibrosis biomarkers, and transient elastography. These parameters were then input into a multilayer perceptron artificial neural network with two hidden layers, and used to create models for predicting significant fibrosis.Results: According to METAVIR score, clinically significant fibrosis (≥F2) was detected in 57.8% of patients. A model based only on Doppler parameters (hepatic artery diameter, hepatic artery systolic and diastolic velocity, splenic artery systolic velocity and splenic artery Resistance Index), predicted significant liver fibrosis with a sensitivity and specificity of75.0% and 60.0%. The addition of unrelated non-invasive tests improved the diagnostic accuracy of Doppler examination. The best model for prediction of significant fibrosis was obtained by combining Doppler parameters, non-invasive markers (APRI, ASPRI, and FIB-4) and transient elastography, with a sensitivity and specificity of 88.9% and 100%.Conclusion: Doppler parameters alone predict the presence of ≥F2 fibrosis with fair accuracy. Better prediction rates are achieved by combining Doppler variables with non-invasive markers and liver stiffness by transient elastography.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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