The Role of Liver Elastography in the Assessment of Hepatic Necroinflammation and Fibrosis in Patients with Chronic Hepatitis B. Infections.

     Significance. Liver elastography has been shown to have good correlation with liver biopsy in determining the presence of necroinflammation and fibrosis in patients with (NAFLD) and chronic hepatitis C. This study aims to detrmine the diagnosis accuracy of both acoustics radiation force impulse (ARFI) elastography and shear wave elastography (SWE) in establishing the presence of moderate to severe hepatic necroinflammation and fibrosis  in patients with chronic hepatitis B.

     Methodology. This is prospective , validation study of ARFI and SWE in the assessment of hepatic necroinflammation and fibrosis as compared  to liver biopsy. Patients included were those with HBeAG -negative chronic hepatitis B. or inactive HBsAG carrier , but without  history of significant alcohol intake or antiviral treatment concomitant other acute or chronic viral hipatitis , fatty liver disease , cirrhosis and /or hepatocellular carcinoma.Statistical analyses were done using SPSS 17 . Sensitivity and specificity was determioned using 2x2 table, and the differences in proportions were tesyed using the z-test, with p values

    Results. A total of 32 patients were included in the study. Both ARFI and SWE have 100% specificity in determining the presence of moderate to severe necroinflammation and fibrosis (F>3, but has low sensitivity in detecting necroinfammation  (33% and 22%,respectivity ) and fibrosis (50% and 33%, respectivity), and fibrosis (50% and 33% respectivity).

    Conclusion. Both ARFI and SWE may serve as good alternatives to liver biopsy as non-invase tests in establishing the presence of moderate to serve necroinflammation  and fibrosis ion patients with chronic hepatitis B.

    Keywords.  chronic hepatitis B. hepatic necroinflammation ; hepatic fibrosis ; acousticradiation force impulse (ARFI) elastography ; shear wave elastography(SWE) ; liver biopsy.