The Role Of ARFI And APRI In Diagnosis Of Liver Fibrosis On Patients With Common Chronic Liver Diseases

Abstract

Objective: This study aimed to investigate the value of liver fibrosis assessment by ARFI and APRI on patients with common chronic liver diseases. Materials and methods: There were 119 patients with chronic hepatitis B and/or C, alcoholic liver disease and non-alcoholic steatohepatitis in this prospective study. All of the patients underwent a liver biopsy for histopathological assessment of liver fibrosis, ARFI and APRI calculation. The results of ARFI and APRI were compared to the histological fibrosis degree. Results: Histopathology of liver fibrosis was evaluated by Metavir score: F0: 9 cases, F1: 57 cases, F2: 23 cases, F3: 19 cases and F4: 11 cases. Shear wave velocity (SWV) significantly correlated with the fibrosis stage (Spearman rho: 0.69, p<0.0001). The area under the ROC curves (AUROCs) for diagnosis of ≥ F2 and ≥ F3 were 0.86 (95% CI: 0.79-0.93) and 0.88 (95% CI: 0.80-0.96), respectively. The cut-off values of SWV for ≥ F2 and ≥ F3 were 1.29 m/s (Se 79.25%, Sp 89.36%, PPV 85.7% and NPV 84.3%) and ≥ 1.36 m/s (Se 96.67%, Sp 86.52%, PPV 70.7%, NPV 98.7%), respectively. APRI significantly correlated with the fibrosis stage (Spearman rho: 0.35, p < 0.0001). AUROCs for diagnosis of ≥ F2 and ≥ F3 were 0.7 (95% CI: 0.56-0.79) and 0.7 (95% CI: 0.85-0.81), respectively. The cut-off values of APRI for diagnosis of ≥ F2 and ≥ F3 were ≥ 0.569 (Se 50.94%, Sp 88.33%, PPV 71.1% and NPV 67.9%) and ≥ 1.163 (Se 40%, Sp 96.63%, PPV 80%, NPV 82.7%), respectively. Conclusions: This study manifested the role of ARFI and APRI as efficacious methods for assessing liver fibrosis on patients with common chronic liver diseases. Increasing SWV and  APRI correlates with higher degree of liver fibrosis. ARFI was significantly better than APRI in evaluating the degree of liver fibrosis.