On the Impact of Nonalcoholic Fatty Liver Disease, Confirmed by Biopsy, on the Results of the Two-Dimensional Shear Elastography

The aim: to study of the effect of NAFLD on the results of shear elastography (based on the results of liver biopsy).  

Materials and methods. We have performed outcome analysis in 137 patients, treated from 2015 to 2016. All patients had chronic diffuse liver diseases and were hospitalized for morphological evaluation and diagnosis clarification. Group 1 (n = 117) with no fat changes in the liver parenchyma. Group 2 (n = 20) with steatosis of the liver.  In our work, we used: scanner Aixplorer (France). All patients underwent shear wave elastography (2DSWE) with the study of the quantitative index of stiffness of liver tissue, staging the results on the Metavir scale.

Results. In the 1st group of patients (without steatosis), in the ROC analysis, cutoff values of elasticity were obtained, the diagnostic efficiency of the Metavir stage of fibrosis was the most optimal: for F2 > 6.8 kPa (sensitivity 85.7, specificity 52, 9, AUROC 0.684); For F3 > 8.5 kPa (sensitivity 91, specificity 57.1, AUROC 0.745); For F4 > 14 kPa (sensitivity 95.7, specificity 52.2, AUROC 0.791). It was found, that the presence of steatosis significantly increases the elasticity of the liver tissue. So, in the subgroup sF0 (with steatosis) was a significant increasing of young's module Ме = 11,2 kPa (95% CI 7,3–17,5) compared to Ме = 6,1 kPa (95% CI 5,4– 9,6) in the subgroup F0 (without steatosis) (P = 0,0168, AUROC = 0,741) and up to Ме=9,95 kPa (95% CI 6,8–13,0) in the subgroup sF0 + sF1 (with steatosis) compared with Ме=6,65 kPa (95%CI 5,6–9,5) of the subgroup F0 + F1 (without steatosis) (P = 0.0295, = 0.707). This increase was, respectively, 83,6% and 49.6%  

Сonclusions. This study confirmed the effectiveness of the shear wave elastography method in assessing the relationship between stiffness parameters and the morphological fibrosis of the liver parenchyma and also contributed to the final confirmation of the effect of steatosis on  liver stiffness.

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