ROLE OF THE FIBROSCAN IN ASSESSING CHRONIC LIVER DISEASES

Abstract

Background  Chronic liver disease (CLD) is a long-term inflammatory process of the liver parenchyma. In 2017 it was estimated that 1.5 billion persons had CLD, ranging from most to least common aetiology NAFLD (60%), HBV (29%), HCV (9%), and ALD (2%). The gold standard test for confirming the diagnosis, staging fibrosis, grading activity, and judging response to treatment in CLD is Liver biopsy. However, it has several limitations; as a result, validated noninvasive tests are required. Transient elastography (FibroScan; Echosens, Paris, France) is a new, non-invasive technique for measuring liver stiffness. Objectives  The aims of the study: To determine the role of Fibroscan in assessing fibrosis and steatosis among a group of patients with chronic liver diseases and compare Fibroscan with other noninvasive methods (APRI, NFS and FIB-4).  Patients and Methods This cross-sectional study was conducted on 100 patients with chronic liver disease at Kurdistan Centre for Gastroenterology and Hepatology (KCGH). Fibroscan was done in an outpatient clinic in Sulaimaniyah from June 2019- November 2020. Required data were collected from the patients based on their Clinical, laboratory and radiological findings. The collected data were analysed using Statistical Package for the Social Sciences (SPSS version 25.0). Results Fifty-nine percent of the patients were males. Causes of CLD among patients were as follows: 58% had hepatitis B virus infection, 18% had hepatitis C virus infection, 16% had nonalcoholic fatty liver disease, 4% had nonalcoholic steatohepatitis, 2% had alcoholic hepatitis, 1% had autoimmune hepatitis, 1% cryptogenic chronic hepatitis. The results revealed a significant association between the results obtained from Fibroscan and FIB-4 (p-value=0.001) and APRI (p-value=0.001). Moreover, the sensitivity and specificity of Fibroscan to FIB-4 were 91.2% and 26.7%, and to APRI were 82.4% and 20%.  Conclusion There was a significant correlation between Fibroscan and FIB-4, APRI. The degree of fibrosis by Fibroscan had a significant association with platelet (PLT) count, alkaline phosphatase (ALP) and serum albumin. There was a significant association between steatosis grades and incidence of HBV, HCV, NAFLD, NASH and , alcoholic hepatitis.