Introduction

  Evaluation of the degree of hepatic fibrogenesis in patients with chronic hepatic diseases by liver biopsy is essential for predicting the risk of hepatic carcinogenesis. It also affects the decision-making of the subsequent treatment such as interferon. Recently, hepatic fibrogenesis could be assessed non-invasively by tissue elastography (Fibroscan 502, echoSens). The degree of hepatic fibrogenesis is assessed by measuring the transmission speed of ultrasound based on the principle that the transmission speed of audible vibrations generated from a probe through the liver tissue becomes faster when the hepatic fibrogenesis is present. In this study, we assessed the feasibility of Fibroscan 502 to evaluate the degree of hepatic fibrogenesis.

 

Methods

  A total of 200 patients, 182 with chronic liver disease and 18 with normal liver, Fibroscan findings were compared with ultrasonic findings and the results of blood examinations. A total of 21 patients who underwent liver biopsies within the past half year were classified by stages (F0-F4), which were then compared with Fibroscan results.

 

Results

(1) Fibroscan value in each stage correlated well with the liver biopsy stages (r=0.479).

(2) 3 patients whose liver echograms were homogenous showed high Fibroscan values and high biopsy stages (F3-4). 10 patients whose liver echograms were homogenous showed high Fibroscan ( 10kPa) values.

(3) Fat showed higher Fibroscan values presumably due to the lower acoustic impedance.

(4) Among liver function indexes, Fibroscan values correlated with platelets, ALB, type IV collagen, and hyaluronic acid, but not with AST, ALT, g-GT, or ALP. Linear correlation with total bilirubin or albumin was higher in the range over 10kPa, which is suggestive of cirrhosis, than in the range below (r=0.354 vs. 0.014, 0.25 vs. 0.053). In contrast, the correlation with platelet count was higher in the range below 20kPa (r=0.517 vs. 0.085).

 

 

(5) Fibroscan was not appliable to patients with atrophic liver or massive ascites.

 

Summary

  Examination by Fibroscan 502 can be easily done non-invasively, and this combined with platelets or a fibrogenesis marker would be valuable in predicting hepatic fibrogenesis accurately.