The Clinical Value Of ARFI (Acoustic Radiation Force Impluse-Imaging) In The Noninvasive Assessment Of Liver Fibrosis

Objective To research the application of ARFI(acoustic radiation force impulse)for the clinical value of liver fibrosis assessment in patients with chronic liver disease,using the technology to evaluate the differences quantitatively and the change characteristics of the VTQ values between the different liver fibrosis groups,at the same time,analysis the sensitivity and specificity and obtain the cut-off value of the VTQ value for the diagnosis of the liver fibrosis.The study can provide the reliable evidence for the timely diagnosis of cirrhosis of the liver,for clinical diagnosis and treatment of liver fibrosis prognosis even provide noninvasive examination index and reliable basis.Methods The 159 patients were selected in the first affiliated hospital of Henan university of TCM from March 2014 to February 2016(109 men and 50 wome n,mean age 41.22±11.47years),including the chronic hepatitis B inpatients after li ver biopsy and the healthy volunteers.According to the diagnostic criteria for ch ronic hepatitis from the meeting established in XIAN in 2000,The pathological s taging of liver fibrosis was referened.S0 of 46(all were the healthy volunteers),S1 of 34,S2 of 32,S3 of 23,S4 of 25,159 totally.We used the Siemens Acuson S2000 ultrasound system(4c1,4.0MHZ,index1.9)to catch the VTQ values,choose th e area in the 6-8 Rib clearance of the right hepatic lobe,in depth of 3-6cm,sta y away the blood vessels etc.Results 1.From the study,we can see that a strong correlation(Spearman r=0.881)between the VTQ value and the liver fibrosis degree.And the increase of the elasticity fallowed the severity degree of hepatic fibrosis.2.The data tells that a high accuracy the ARFI had reached for evaluati ng the grade S2 and upwards(AUROC>95%),especially for the grade S4(AUR OC=1.000).By the ROC curve method,the cut-offs for differernt grades S1-S4 were 1.23m/s,1.41m/s,1.62m/s,2.03m/s respectively.3.There had a significant differences between the control group,the liver f ibrosis and cirrhosis group after comparing one to another(P<0.05).Conclusion Early diagnosis and therapy can reverse cirrhosis,the different degree s of hepatic fibrosis make the different hardness of the liver.And the increase of the elasticity fallowed the severity degree of hepatic fibrosis.ARFI can discover the differences with its features such as non-invasive,easily operating,rapid,and accurate,etc,which can offer the diagnostic basis in the clinical diagnosis and tr eatment of liver fibrosis and prognosis.