Does Hepatosteatosis Affect Shear-Wave Elastography Values in Chronic Hepatitis Patients with the Same Histological Fibrosis Grade?

Background/

Objectives

The Ishak and Knodell classifications are used to evaluate fibrosis on percutaneous liver biopsy (PLB) in chronic hepatitis (CH). Hepatosteatosis (HS) can also be seen in PLBs performed on patients. In addition to PLB, the shear-wave elastography (SWE) technique is increasingly used to evaluate liver fibrosis. Whether the presence of HS contributed to fibrosis in CH cases that underwent PLB was evaluated by comparing SWE and Ishak-Knodell grades.

Methods

CH cases were divided into three groups based on the presence of HS on biopsy and the percentage of HS (none, <10%, or ≥10%). Ishak-Knodell fibrosis grades and SWE values in kilopascal (kPa) were available for all included cases. Fibrosis scores and kPa values were compared within themselves and between groups for all three groups. Whether steatosis affected kPa results within the same fibrosis grades was evaluated.

Results

There were 236 patients with CH: 109 (46.2%) had HS on liver biopsy, and 127 (53.8%) did not. Among the 109 patients with HS, 78 (71.5%) had pathological steatosis ≥ 10%. In all Ishak and Knodell grades (except F3), there was no significance between the liver stiffness values (kPa) of those with ≥10% HS and those with HS < 10%/none (p > 0.05). For the Ishak-Knodell F3 grade, there was a significant difference in both comparisons (p < 0.05).

Conclusions

Liver kPa results are compatible with fibrosis grades, and SWE can be easily applied in the follow-up of CH patients with HS. In this way, unnecessary invasive procedures are prevented, and patient comfort can be maintained.