TITLE:
Usefulness of Liver and Spleen Acoustic Radiation Force Impulse (ARFI) for the Evaluation of Cirrhotic Patients
AUTHORS:
Luciana Barbosa, Catarina Oliveira, Alexandra Fernandes, Margarida Marques, João Pereira, Carlos Sofia, Filipe Caseiro-Alves, Maria José Noruegas
KEYWORDS:
Liver Cirrhosis, Child-Pugh Classification, Liver Stiffness, Spleen Stiffness, ARFI
JOURNAL NAME:
Open Access Library Journal,
Vol.1 No.8,
November
13,
2014
ABSTRACT: Objective: To evaluate the correlation between ARFI and Child-Pugh classification. Secondary Aims: 1) To compare ARFI values (hepatic, splenic and splenohepatic index) from cirrhotic to normal population; 2) To correlate biochemical parameters of liver function and ARFI. Materials and Methods: 58 cirrhotic patients (referenced to US for surveillance or to clarify any hepatic decompensation) were included in this prospective study, as well as 38 healthy subjects who underwent ultrasonography for other reasons than hepatic evaluation. All had ARFI liver and spleen evaluation on ACUSON S2000 ARFI equipment. The best cut-off liver and spleen values for the diagnosis of cirrhosis in comparison to the normal subjects were determined using SPSS® v20. Results: Mean liver ARFI values in controls and cirrhotic patients were respectively 1.18 ± 0.22 m/s and 2.93 ± 0.50 m/s. The ROC curve demonstrated an AUC 0.998 and the best cut-off was 1.89. Mean spleen ARFI values in controls and cirrhotic patients were respectively 2.60 ± 0.42 m/s and 3.03 ± 0.71. The ROC curve demonstrated an AUC 0.766 and the best cut-off was 2.73 m/s. The splenohepatic index showed a worse AUC than ARFI liver. A weak correlation was found between the ARFI liver and Child-Pugh. We found no statistically significant differences for spleen ARFI values and Child-Pugh. We found a statistically significant correlation between liver ARFI and bilirubin, ALKP, GGT, AST and AST/ALT ratio; and with spleen ARFI and ALKP and AST/ALT ratio. Conclusion: We showed that there is a tendency of higher levels of liver ARFI values for higher Child-Pugh classification suggesting a definite trend for higher values with more severe disease.