EVALUATION OF FIBROSIS USING A NON-INVASIVE, FAST, RELIABLE METHOD IN CHRONIC HEPATITIS CASES: ARFI (ACOUSTIC RADIATION FORCE IMPULSE) ELASTOGRAPHY

Objective: The aim of our study is to investigate the contribution of ARFI elastography to the diagnostics in detecting fibrosis and determining its extent in chronic hepatitis cases by means of comparison with histopathological findings. Materials and methods: 122 patients who were diagnosed with chronic hepatitis and referred to our clinic for liver biopsy between June 2018 - August 2018 were included in the retrospective study. Shear wave velocity measurements were performed 10 times on the right lobes of the livers. Mean ARFI velocity values were compared with the values for fibrosis within the ISHAK classification. Results: The first comparison was made between patients with stage <= F1 fibrosis and patients with stage >= F2 fibrosis. Accordingly, in detecting the presence of fibrosis for an optimal cut-off value equal to 126 m/s, ARY elastography displayed 77% sensitivity and 68% specificity in differentiating between the two groups. The second comparison was made between two patient groups with stage <= F2 and >= F3 fibrosis in order to detect significant fibrosis. Accordingly, in determining significant fibrosis for an optimal cut-off value equal to 1.45 mls, ARFI elastography displayed 85% sensitivity and 87% specificity in differentiating between the two groups. The third comparison was made between two patient groups with stage <= F4 and stage >= F5 fibrosis in order to differentiate between cirrhosis cases and other fibrosis groups. For an optimal cut-off value equal to 1.64 m/s, ARFI elastography displayed 100% sensitivity and 84% specificity in differentiating between the two groups. Conclusion: Our study has provided reliable results in terms of revealing the presence of significant fibrosis and determining cirrhotic processes using ARFI elastography. ARFI elastography is a method that can replace biopsy in a majority of cases of chronic liver disease.