ROLE OF ELASTOGRAPHY AS A SCREENING TEST IN DETECTING EARLY LIVER FIBROSIS IN PATIENTS WITH NORMAL LIVER ARCHITECTURE ON CONVENTIONAL ULTRASOUND

Role of Elastography in Detecting Early Liver Fibrosis

Abstract

Cirrhosis of liver is characterized by replacement of normal liver tissue by fibrosis, scar tissue and regenerative nodules. Clinical manifestations like ascites or splenomegaly help point to the diagnosis of cirrhosis but the early detection of fibrosis is not possible by simple grey scale ultrasound as these features generally emerge late.
Objective: The objective of the study was to check the sensitivity of detecting early liver fibrosis by ultrasound elastography in patients who have normal liver architecture on conventional ultrasound but persistent deranged liver function tests.
Study Design: It was a cross sectional study.
Place and Duration of Study: This study was conducted in the Department of Radiology, Combined Military Hospital Lahore. Six months from 30th April to November 2013.
Material and Methods: Three hundred (300) patients fulfilling the inclusion criteria were selected for this study. Combined Autocorrelation Method is the basis of the technique that calculated relative hardness of tissue from the degree of tissue distortion and this information is displayed as a color image. Color coding and amount of displacement of tissue enabled us to detect early fibrotic changes. Young’s modulus elasticity formula that quantifies the tissue stiffness was applied. Hard tissue has higher strain ratio so higher Young’s modulus than soft tissue.
Results: The mean age of the patients was 53.9 ± 7.1 years. In the distribution of patients by sex, there were 186 (62.0%) male and 114 (38.0%) female patients. In the distribution of patients by frequency of liver fibrosis, there were 220 (73.3%) patients having liver fibrosis and 80 (26.7%) patients had no liver fibrosis.
Conclusion: It is concluded that real time ultrasound elastography is a clinically useful test for detecting early liver fibrosis and was detected in 73.3% patients in our study.