The Value Of Shear Wave Elastography In Evaluating Hepatic Fibrosis In Autoimmune Liver Disease And Its Influencing Factors

Objective:To evaluate the diagnostic efficacy of shear wave elastography(SWE)for the degree of liver fibrosis in patients with autoimmune liver disease(AILD)and the factors influencing the accuracy SWE measurement.Methods:From January 2018 to January 2023,a total of 78 patients with AILD diagnosed by Shengjing Hospital liver biopsy were included,there were 26,23,9 and20 patients with F0-1,F2,F3 and F4 stages respectively.The data of SWE,liver biopsy and serology were collected and the APRI and FIB-4 were calculated.SPSS26.0 software was used for statistical analysis,and the receiver operating characteristic(ROC)curve was drawn according to the pathological results as the gold standard.The difference of ROC curve was compared with Z test,Youden index was used to calculate the diagnostic threshold of different degrees of hepatic fibrosis,and the influencing factors were analyzed.Spearman correlation analysis was used,and Logistic regression model was used for multivariate analysis.Results: There was a positive correlation between the degree of hepatic fibrosis and the values of liver stiffness,serum APRI and FIB-4 measured by SWE(r=0.672,0.461,0.487,P<0.05).The area under the ROC curve of SWE diagnosis F≥2was 0.791,the cut-off value was 7.8 k Pa,the sensitivity and specificity were 82.4%and 74.1% respectively,the area under the ROC curve of SWE for stage F≥3 was0.853,the cut-off value was 11.0 k Pa,the sensitivity and specificity were 72.4% and85.7% respectively The area under the ROC curve was 0.872 and the cut-off value was 12.4 k Pa.The sensitivity and specificity of SWE were 75.0% and 87.9%,respectively.The AUC of F≥2,F≥3 and F4 were 0.701,0.853,0.872;0.682,0.773,0.778,respectively;the AUC of APRI,FIB-4 and SWE were0.701,0.853,0.872,0.682,0.773,0.778,respectively,SWE was superior to FIB-4(Z=2.05,P<0.05),F≥3 and F4,and SWE was superior to APRI(Z=2.26,2.81,P<0.05).The results of multivariate analysis showed that the level of inflammation was an independent predictor of significant liver fibrosis in patients with AILD(OR =4.49,P<0.05);liver inflammation and PLT were independent predictors of cirrhosis in patients with AILD(OR=6.60,0.98,P<0.05).Conclusions: SWE has a good diagnostic ability in evaluating the stages of liver fibrosis in patients with AILD,and is superior to serological models in the advanced stages of fibrosis and above,it can be used as an effective non-invasive method to evaluate the degree of liver fibrosis in patients with AILD.