Diagnostic value of acoustic radiation force impulse combined with transient elastography for inflammatory liver fibrosis

Objective To evaluate the diagnostic value of acoustic radiation force impulse (ARFI) imaging combined with transient elastography (TE) for liver fibrosis in chronic hepatitis B (CHB) patients. Methods One hundred and twenty-one patients with CHB were included from October 2015 to June 2017 at the Fourth Hospital of Harbin Medical University. Liver biopsy, routine biochemical tests, ARFI, and TE were carried out. The age, AST, ALT, ARFI, and TE were calculated and analyzed by one-way ANOVA, followed by pairwise comparisons using the SNK-q test. The results of ARFI and TE were compared with pathological results. Using the pathological stage of liver fibrosis as the ″golden standard″, the accuracy of ARFI and TE in diagnosing different stages of liver fibrosis were assessed by receiver operating characteristic (ROC) curve analysis. Logistic regression was used to predict the risk of joint diagnosis, and ROC curve was drawn based on the predicted value to compare the diagnostic value of ARFI, TE, and their combination in S≥1 and S≥2 liver fibrosis. Results ARFI and TE were positively correlated with the fibrosis degree, and the correlation coefficients were 0.789 and 0.845, respectively (P 0.05), but the sensitivity, specificity, and accuracy of the combination were improved. The AUROC of the combined diagnosis for S≥2 was 0.949, which was only better than that of ARFI alone (P=0.009), but the sensitivity and accuracy of the combination were improved. Conclusions ARFI combined with TE improves the diagnosis of S≥1 and S≥2 liver fibrosis.