Lorena C. Castro-Solari, Departamento de Gastroenterología, Clínica Las Condes, Santiago, Chile
Javier Brahm, Departamento de Gastroenterología, Clínica Las Condes, Santiago, Chile
Leyla Nazal, Departamento de Gastroenterología, Clínica Las Condes, Santiago, Chile
Daniela Simian, Departamento de Investigación, Clínica Las Condes, Santiago, Chile
Andrea Jiménez, Departamento de Gastroenterología, Clínica Las Condes, Santiago, Chile
Roberto Segovia, Departamento de Gastroenterología, Clínica Las Condes, Santiago, Chile
Andres O`Brien, Departamento de Diagnóstico por Imágenes. Clínica Las Condes, Santiago, Chile
Guillermo Silva, Departamento de Gastroenterología, Clínica Las Condes, Santiago, Chile
Non-invasive techniques are useful to quantify the degree of liver fibrosis. Hepatic elastography by ARFI (Acoustic Radiation Force Impulse) has been less studied in our setting.
Objective: To describe patients with chronic liver disease (CLD) studied by ARFI, evaluating concordance, advantages or limitations compared with non-invasive biochemical scores (APRI and FIB-4) to graduate liver fibrosis.
Patients and methods: Retrospective and descriptive study of patients undergoing ARFI between 2013-2019 with a clinical and laboratory history obtained from an electronic medical record. Descriptive statistics and association by c2 were used, with a significance value of p < 0.05.
Results: ARFI was performed 815 times in 731 patients; 488 subjects met inclusion criteria. ARFI was compared between more frequent pathologies. There was a higher frequency of advanced fibrosis (F3 - F4) in Alcoholic Liver Disease (ALD) (42%) and Hepatitis C virus (HCV) (29%) (p < 0.001) and absence or minimal fibrosis (F0-F1) in Non-Alcoholic Fatty Liver Disease (NAFLD) (89%), Hepatitis B Virus (HBV) (77%) and Autoimmune Liver Disease (73%) (p < 0.001). Splenomegaly was associated with F3 - F4 (p < 0.001). Greater liver echogenicity was observed in NAFLD (93%), ALD (84%) and HCV (74%) (p < 0.001). The ARFI, FIB-4 and APRI score tended to increase according to the degree of fibrosis, being concordant in F3-4. When comparing F0-F1 by ARFI with FIB-4 and APRI, there was dispersion of the values in the serological scores.
Conclusion: FIB-4, APRI and ARFI can be helpful in estimating F3-F4, however, they could underestimate or overestimate severity in F0-F1. ARFI would add relevant morphological aspects in CLD.
Keywords: Chronic liver disease; Liver fibrosis; ARFI imaging; Elastography; Serologic test