Diagnostic efficacy of shear wave elastography in evaluating chronic hepatitis B liver fibrosis and related influencing factors

Objective To investigate the diagnostic efficiency of shear wave elastography ( SWE) in evaluating chronic hepatitis B ( CHB) liver fibrosis and related influencing factors. Methods A total of 147 CHB patients who visited Shengjing Hospital of China Medical University from January 2016 to September 2017 were enrolled. SWE was performed for all patients, and liver biopsy was performed within one week after SWE. General information and serological test results of the patients were collected. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data; the chi-square test was used for comparison of categorical data between groups.The receiver operating characteristic ( ROC) curve was plotted to evaluate diagnostic efficiency, and the logistic regression model was used to determine the factors associated with the accuracy of SWE in assessing liver fibrosis stage. Results With liver fibrosis stage determined by liver histology as the standard, the areas under the ROC curve of SWE in the diagnosis of ≥F1, ≥F2, ≥F3, and ≥F4 liver fibrosis were0. 824, 0. 880, 0. 914, and 0. 986, respectively, with sensitivities of 91. 0%, 91. 7%, 87. 0%, and 88. 9%, respectively and specificities of 66. 0%, 82. 8%, 66. 0%, and 94. 9%, respectively, at the optimal cut-off values of 6. 1 kPa, 7. 0 k Pa, 8. 1 kPa, and 10. 0 k Pa, respectively. The positive predictive values were 85. 0%, 78. 6%, 48. 3%, and 53. 3%, respectively, and the negative predictive values were 77. 5%, 93. 5%, 97. 2%, and 99. 2%, respectively. According to the results of liver biopsy, of all 147 patients, 94 had an accurate diagnosis based on SWE, while 53 had an inaccurate diagnosis; there were significant differences between these two groups in alanine aminotransferase, aspartate aminotransferase, and liver inflammation grade ( Z =-4. 211、-4. 649、-3. 513, all P < 0. 01) . Liver inflammation grade ( odds ratio [OR]= 0. 552, 95% confidence interval [CI]: 0. 317-0. 963, P = 0. 028) was an independent influencing factor for the diagnostic accuracy of SWE, and it had a significant effect on SWE in diagnosing liver fibrosis in the case of stage F0 liver fibrosis ( OR= 1. 809, 95% CI: 2. 305-51. 195) and stage F2 liver fibrosis ( OR = 1. 345, 95% CI: 1. 037-13. 647) . Conclusion Liver stiffness measured by SWE has good diagnostic efficacy in assessing liver fibrosis stage, and the accuracy of liver fibrosis stage assessment is affected by liver inflammation stage.