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KMID : 1103920130190040389
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Korean Journal of Hepatology
2013 Volume.19 No. 4 p.389 ~ p.398
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Ultrasonographic scoring system score versus liver stiffness measurement in prediction of cirrhosis
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Moon Kyoung-Min
Kim Ga-Eun
Baik Soon-Koo
Choi Eun-Hee
Kim Moon-Young
Kim Hyoun-A
Cho Mee-Yon
Shin Seung-Yong
Kim Jung-Min
Park Hong-Jun
Kwon Sang-Ok
Eom Young-Woo
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Abstract
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Background/Aims: We compared the cirrhosis-prediction accuracy of an ultrasonographic scoring system (USSS) combining six representative sonographic indices with that of liver stiffness measurement (LSM) by transient elastography, and prospectively investigated the correlation between the USSS score and LSM in predicting cirrhosis.
Methods: Two hundred and thirty patients with chronic liver diseases (187 men, 43 women; age, 50.4±9.5 y, mean±SD) were enrolled in this prospective study. The USSS produces a combined score for nodularity of the liver surface and edge, parenchyma echogenicity, presence of right-lobe atrophy, spleen size, splenic vein diameter, and abnormality of the hepatic vein waveform. The correlations of the USSS score and LSM with that of a pathological liver biopsy (METAVIR scoring system: F0?F4) were evaluated.
Results: The mean USSS score and LSM were 7.2 and 38.0 kPa, respectively, in patients with histologically overt cirrhosis (F4, P=0.017) and 4.3 and 22.1 kPa in patients with fibrotic change without overt cirrhosis (F0?F3) (P=0.025). The areas under the receiver operating characteristic (ROC) curves of the USSS score and LSM for F4 patients were 0.849 and 0.729, respectively. On the basis of ROC curves, criteria of USSS ≥6: LSM ≥17.4 had a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 89.2%:77.6%, 69.4%:61.4%, 86.5%:83.7%, 74.6%:51.9% and 0.83:0.73, respectively, in predicting F4.
Conclusions: The results indicate that this USSS has comparable efficacy to LSM in the diagnosis of cirrhosis.
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KEYWORD
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Ultrasonography, Elastography, Cirrhosis, Biopsy
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