Background: Non-alcoholic fatty liver disease (NAFLD) has emerged a major
challenge and become the leading indication for liver transplantation. We
aimed to assess the applicability and performance of real-time elastography
(RTE) in diagnosis of liver fibrosis in patients with NAFLD compared with
NAFLD fibrosis score (NFS) and FIB-4 index. Patients and Methods: A
prospective case-control study was conducted on 260 subjects attended Hepatology,
Gastroenterology and Infectious diseases and Internal Medicine
departments in Benha University Hospital from Marsh 20, 2018, to September
1, 2019 and divided into group I included 200 cases with NAFLD and
group II included 60 healthy control subjects. Results: There was statistically
significant increase in FIB-4 scores between two groups (1.39 ± 1.02 and
−0.75 ± 0.32 respectively with p < 0.001), also there was statistically significant
increase in NAFLD fibrosis score mean ± SD between two groups (−1.74
± 1.17 and −2.75 ± 0.91 respectively with p < 0.001). Fibrosis stages in
NAFLD patients significantly higher than in control group diagnosed by RTE
(P = 0.001). There was an agreement between RTE and FIB-4 index (93%)
and NAFLD fibrosis score (86%). Diagnostic performance of RTE in advanced
liver fibrosis ≥ F3 was assessed in comparing with FIB-4 index show sensitivity
90%, specificity 93.3%, PPV 60%, NPV 98.8% and accuracy 93% with AUC0.917
(p = 0.001) and in comparing with NAFLD fibrosis score sensitivity 52.6%,
specificity 93.8%, PPV 66.7%, NPV 98.4% and accuracy 86% with AUC 0.732
(p = 0.002). Conclusion: Real time elastography could be valuable in diagnosis
of fibrosis in NAFLD especially in cases more than F3 score. |
