Assessment of liver fibrosis using transient elastography in patients with alcoholic liver disease

Pierre Nahon, Adrien Kettaneh, Iulia Tengher-Barna, Marianne Ziol, Victor de Lédinghen, Catherine Douvin, Patrick Marcellin, Nathalie Ganne-Carrié, Jean-Claude Trinchet, Michel Beaugrand
Journal of Hepatology 2008, 49 (6): 1062-8

BACKGROUND/AIMS: The aim of this study was to assess the accuracy of liver stiffness measurement (LSM) for the diagnosis of extensive fibrosis and cirrhosis in patients with alcoholic liver disease (ALD).

METHODS: One hundred and seventy-four patients with ALD were enrolled in four liver units and underwent concomitant liver biopsy and LSM. Fibrosis was assessed using the Brunt et al. and the Chevallier et al. scoring systems. Steatosis and histological alcoholic hepatitis (HAH) were quoted in classes.

RESULTS: Twenty-seven patients had inadequate biopsy or LSM. Distribution in 147 patients according to the Brunt score (median LSM) was: F1: n=13 (5.7kPa); F2: n=24 (8.3kPa); F3: n=31 (17.5kPa) and F4: n=79 (40.9kPa) (P<0.0001). LSM was correlated with the amount of fibrosis according to the Chevallier score (r=0.70, P<0.0001). LSM was correlated to fibrosis stage (tau beta, 0.53; P<0.0001) and HAH (tau beta, 0.30; P<0.0001). In multivariate analysis, fibrosis was the only parameter correlated with LSM. The areas under the ROC curve were 0.94 and 0.87 for the diagnosis of extensive fibrosis (Brunt et al. score > or =3) and cirrhosis, respectively (threshold-values: 12.9 and 22.6kPa).

CONCLUSIONS: LSM accurately assesses extensive fibrosis and cirrhosis in alcoholic patients.

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