Reliability of transient elastography for the diagnosis of advanced fibrosis in chronic hepatitis C

Background: Transient elastography (TE) has received increasing attention as a means to evaluate disease progression in patients with chronic liver disease. Aim: To assess the value of TE for predicting the stage of fibrosis. Methods: Liver biopsy and TE were performed in 150 consecutive patients wi...

Descripción completa

Detalles Bibliográficos
Autores: Arena, Umberto, Vizzutti, Francesco, Abraldes, Juan G., Corti, G., Stasi, C., Moscarella, S., Milani, S., Lorefice, E., Petrarca, A., Romanelli, R. G., Laffi, G., Bosch i Genover, Jaume, Marra, F., Pinzani, Massimo
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2008
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/18660
Acceso en línea:https://hdl.handle.net/2445/18660
Access Level:acceso abierto
Palabra clave:Hepatitis C
Ecografia
Diagnòstic per la imatge
Fetge
Ultrasonic imaging
Diagnostic imaging
Liver
id ES_86307ae24ea38e1bcfe7663f45a04fa1
oai_identifier_str oai:diposit.ub.edu:2445/18660
network_acronym_str ES
network_name_str España
repository_id_str
spelling Reliability of transient elastography for the diagnosis of advanced fibrosis in chronic hepatitis CArena, UmbertoVizzutti, FrancescoAbraldes, Juan G.Corti, G.Stasi, C.Moscarella, S.Milani, S.Lorefice, E.Petrarca, A.Romanelli, R. G.Laffi, G.Bosch i Genover, JaumeMarra, F.Pinzani, MassimoHepatitis CEcografiaDiagnòstic per la imatgeFetgeHepatitis CUltrasonic imagingDiagnostic imagingLiverBackground: Transient elastography (TE) has received increasing attention as a means to evaluate disease progression in patients with chronic liver disease. Aim: To assess the value of TE for predicting the stage of fibrosis. Methods: Liver biopsy and TE were performed in 150 consecutive patients with chronic hepatitis C-related hepatitis (92 men and 58 women, age 50.6 (SD 12.5) years on the same day. Necro-inflammatory activity and the degree of steatosis at biopsy were also evaluated. Results: The areas under the curve for the prediction of significant fibrosis (⩾F2), advanced fibrosis (⩾F3) or cirrhosis were 0.91, 0.99 and 0.98, respectively. Calculation of multilevel likelihood ratios showed that values of TE <6 or ⩾12, <9 or ⩾12, and <12 or ⩾18, clearly indicated the absence or presence of significant fibrosis, advanced fibrosis, and cirrhosis, respectively. Intermediate values could not be reliably associated with the absence or presence of the target condition. The presence of inflammation significantly affected TE measurements in patients who did not have cirrhosis (p<0.0001), even after adjusting for the stage of fibrosis. Importantly, TE measurements were not influenced by the degree of steatosis. Conclusions: TE is more suitable for the identification of patients with advanced fibrosis than of those with cirrhosis or significant fibrosis. In patients in whom likelihood ratios are not optimal and do not provide a reliable indication of the disease stage, liver biopsy should be considered when clinically indicated. Necro-inflammatory activity, but not steatosis, strongly and independently influences TE measurement in patients who do not have cirrhosis.BMJ Group2008info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/18660Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció digital del document publicat a: http://dx.doi.org/10.1136/gut.2008.149708Gut, 2008, vol. 57, núm. 9, p. 1288-1293http://dx.doi.org/10.1136/gut.2008.149708(c) BMJ Publishing Group Ltd and British Society of Gastroenterology, 2008info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/186602026-05-27T06:46:51Z
dc.title.none.fl_str_mv Reliability of transient elastography for the diagnosis of advanced fibrosis in chronic hepatitis C
title Reliability of transient elastography for the diagnosis of advanced fibrosis in chronic hepatitis C
spellingShingle Reliability of transient elastography for the diagnosis of advanced fibrosis in chronic hepatitis C
Arena, Umberto
Hepatitis C
Ecografia
Diagnòstic per la imatge
Fetge
Hepatitis C
Ultrasonic imaging
Diagnostic imaging
Liver
title_short Reliability of transient elastography for the diagnosis of advanced fibrosis in chronic hepatitis C
title_full Reliability of transient elastography for the diagnosis of advanced fibrosis in chronic hepatitis C
title_fullStr Reliability of transient elastography for the diagnosis of advanced fibrosis in chronic hepatitis C
title_full_unstemmed Reliability of transient elastography for the diagnosis of advanced fibrosis in chronic hepatitis C
title_sort Reliability of transient elastography for the diagnosis of advanced fibrosis in chronic hepatitis C
dc.creator.none.fl_str_mv Arena, Umberto
Vizzutti, Francesco
Abraldes, Juan G.
Corti, G.
Stasi, C.
Moscarella, S.
Milani, S.
Lorefice, E.
Petrarca, A.
Romanelli, R. G.
Laffi, G.
Bosch i Genover, Jaume
Marra, F.
Pinzani, Massimo
author Arena, Umberto
author_facet Arena, Umberto
Vizzutti, Francesco
Abraldes, Juan G.
Corti, G.
Stasi, C.
Moscarella, S.
Milani, S.
Lorefice, E.
Petrarca, A.
Romanelli, R. G.
Laffi, G.
Bosch i Genover, Jaume
Marra, F.
Pinzani, Massimo
author_role author
author2 Vizzutti, Francesco
Abraldes, Juan G.
Corti, G.
Stasi, C.
Moscarella, S.
Milani, S.
Lorefice, E.
Petrarca, A.
Romanelli, R. G.
Laffi, G.
Bosch i Genover, Jaume
Marra, F.
Pinzani, Massimo
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Hepatitis C
Ecografia
Diagnòstic per la imatge
Fetge
Hepatitis C
Ultrasonic imaging
Diagnostic imaging
Liver
topic Hepatitis C
Ecografia
Diagnòstic per la imatge
Fetge
Hepatitis C
Ultrasonic imaging
Diagnostic imaging
Liver
description Background: Transient elastography (TE) has received increasing attention as a means to evaluate disease progression in patients with chronic liver disease. Aim: To assess the value of TE for predicting the stage of fibrosis. Methods: Liver biopsy and TE were performed in 150 consecutive patients with chronic hepatitis C-related hepatitis (92 men and 58 women, age 50.6 (SD 12.5) years on the same day. Necro-inflammatory activity and the degree of steatosis at biopsy were also evaluated. Results: The areas under the curve for the prediction of significant fibrosis (⩾F2), advanced fibrosis (⩾F3) or cirrhosis were 0.91, 0.99 and 0.98, respectively. Calculation of multilevel likelihood ratios showed that values of TE <6 or ⩾12, <9 or ⩾12, and <12 or ⩾18, clearly indicated the absence or presence of significant fibrosis, advanced fibrosis, and cirrhosis, respectively. Intermediate values could not be reliably associated with the absence or presence of the target condition. The presence of inflammation significantly affected TE measurements in patients who did not have cirrhosis (p<0.0001), even after adjusting for the stage of fibrosis. Importantly, TE measurements were not influenced by the degree of steatosis. Conclusions: TE is more suitable for the identification of patients with advanced fibrosis than of those with cirrhosis or significant fibrosis. In patients in whom likelihood ratios are not optimal and do not provide a reliable indication of the disease stage, liver biopsy should be considered when clinically indicated. Necro-inflammatory activity, but not steatosis, strongly and independently influences TE measurement in patients who do not have cirrhosis.
publishDate 2008
dc.date.none.fl_str_mv 2008
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/18660
url https://hdl.handle.net/2445/18660
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció digital del document publicat a: http://dx.doi.org/10.1136/gut.2008.149708
Gut, 2008, vol. 57, núm. 9, p. 1288-1293
http://dx.doi.org/10.1136/gut.2008.149708
dc.rights.none.fl_str_mv (c) BMJ Publishing Group Ltd and British Society of Gastroenterology, 2008
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) BMJ Publishing Group Ltd and British Society of Gastroenterology, 2008
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv BMJ Group
publisher.none.fl_str_mv BMJ Group
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869412355769630720
score 15,301603

Similares en LA Referencia