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World J Gastroenterol. 2015 Jan 21;21(3):953-60. doi: 10.3748/wjg.v21.i3.953.

Transient elastography improves detection of liver cirrhosis compared to routine screening tests.

Author information

1
Thomas Göbel, Janine Schadewaldt-Tümmers, Dieter Häussinger, Andreas Erhardt, Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Düsseldorf, 40225 Düsseldorf, Germany.

Abstract

AIM:

To investigate the diagnostic significance of transient elastography (TE) in a daily routine clinical setting in comparison to clinical signs, laboratory parameters and ultrasound.

METHODS:

TE, ultrasound, laboratory parameters and cutaneous liver signs were assessed in 291 consecutive patients with chronic liver disease of various aetiologies who underwent liver biopsy in daily routine.

RESULTS:

Sensitivity of TE for the detection of liver cirrhosis was 90.4%, compared to 80.1% for ultrasound, 58.0% for platelet count and 45.1% for cutaneous liver signs (P < 0.0001 for comparisons with histology). AUROC for TE was 0.760 (95%CI: 0.694-0.825). Combination of TE with ultrasound increased sensitivity to 96.1% and AUROC to 0.825 (95%CI: 0.768-0.882). TE correlated with laboratory parameters of cirrhosis progression like albumin (r = -0.43), prothrombin time (r = -0.44), and bilirubin (r = 0.34; P < 0.001 for each). Particularly, in patients with Child Pugh score A or normal platelet count TE improved sensitivity for the detection of liver cirrhosis compared to ultrasound by 14.1% (P < 0.04) and 16.3% (P < 0.02), respectively.

CONCLUSION:

Transient elastography is superior to routine diagnostic tests allowing detection of liver cirrhosis in additional 10%-16% of patients with chronic liver disease that would have been missed by clinical examinations.

KEYWORDS:

Chronic hepatitis; Fibroscan; Liver cirrhosis; Liver disease; Transient elastography

PMID:
25624730
PMCID:
PMC4299349
DOI:
10.3748/wjg.v21.i3.953
[Indexed for MEDLINE]
Free PMC Article

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