Article Type

Original Study


Objective The aim of this study was to evaluate the diagnostic accuracy of real-time shear wave elastography (SWE) in assessment of liver fibrosis in patients with chronic hepatitis C compared with the liver biopsy. Background Chronic hepatitis C is a global disease and one of the most intractable clinical problems in Egypt with drastic consequences. Diagnosis and grading of hepatic fibrosis is one of the chief clues in selection of appropriate plan of treatment and follow-up. Patient and methods This study included 161 patients (male/female = 112/49) with chronic hepatitis C and 30 healthy control (male/female = 25/5). Liver biopsy and transient elastography were done for all patients before SWE examination. Results Different liver fibrosis stages were observed (13.7% F0, 20% F1, 11.2% F2, 23.6% F3, and 31.1% F4); the reference range of liver stiffness in the diseased group by SWE was 5.2–22.5 kPa and control group was 2–4.5 kPa. There was significant discrimination between mild fibrosis (F1), with reference range from 4 to 5.3 kPa, and significant fibrosis of at least F2, with area under the receiver operating characteristic curve of 0.994 and P value of less than 0.0001, and between mild fibrosis F2 (5.7–12.2 kPa) and severe fibrosis F3 (13.2–21.6 kPa) and F4 cirrhosis of at least 22.1 kPa, with area under the receiver operating characteristic curve of 0.995 and P value of less than 0.0001. There was strong correlation between SWE staging of fibrosis and that of liver biopsy (Kendall's τ-b was 0.892). Conclusion Being noninvasive and regarding its accuracy SWE can replace liver biopsy with its related complication dilemma. SWE can also replace transient elastography for being a real-time treatment with enhanced accuracy.