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Real-Time Elastography for Noninvasive Assessment of Liver Fibrosis in Chronic Viral Hepatitis

Mireen Friedrich-Rust1, Mei-Fang Ong1, Eva Herrmann1, Volker Dries2, Panagiotis Samaras1, Stefan Zeuzem1 and Christoph Sarrazin1

1 Department of Internal Medicine II, Saarland University Hospital, Kirrbergerstrasse, Bldg. 41, Homburg/Saar 66421, Germany.
2 Institute of Pathology, Mannheim, Germany.


Figure 1
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  		Fig. 1 —Tissue elasticity distribution represented as color-coded images over conventional B-mode image. Image presents example of 34-year-old healthy female subject.

 

Figure 2
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  		Fig. 2A —Box plots show correlation between noninvasive tests and histologic results from liver biopsy. Top and bottom of boxes represent first and third quartiles, respectively. Length of box represents interquartile range within which 50% of values are located. Thick line through each box represents median. Error bars mark minimum and maximum values (range). Small circles represent outliers. Real-time elastography. Skewed data for control subjects might be explained by inhomogeneous group of patients, whereas skewed data for fibrosis stage F2 can be explained by small number of patients in this group.

 

Figure 3
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  		Fig. 2B —Box plots show correlation between noninvasive tests and histologic results from liver biopsy. Top and bottom of boxes represent first and third quartiles, respectively. Length of box represents interquartile range within which 50% of values are located. Thick line through each box represents median. Error bars mark minimum and maximum values (range). Small circles represent outliers. Aspartate transaminase-to-platelet ratio index (APRI). Skewed data are equalized when using log scale for APRI score.

 

Figure 4
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  		Fig. 2C —Box plots show correlation between noninvasive tests and histologic results from liver biopsy. Top and bottom of boxes represent first and third quartiles, respectively. Length of box represents interquartile range within which 50% of values are located. Thick line through each box represents median. Error bars mark minimum and maximum values (range). Small circles represent outliers. Elasticity-laboratory combination values for each fibrosis stage.

 

Figure 5
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  		Fig. 3 —Receiver operating characteristic curves for realtime elastography (light gray), aspartate transaminase-to-platelet ratio index (dark gray), and combination of real-time elastography and blood markers (black) for diagnosis of significant fibrosis (F ≥ F2).

 

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