P-58 CONCORDANCE BETWEEN ECOGRAPHY AND THE CONTINUOUS ATTENUATION PARAMETER (CAP) BY TRANSIENT ELASTOGRAPHY FOR THE DIAGNOSIS OF LIVER STEATOSIS

Introduction

Abdominal ultrasound is the test of choice for the screening of liver steatosis (LS) however it has a poor performance (20%). Transient elastography (TE) through the Continuous Attenuation Parameter (CAP) has shown an adequate correlation with the degree of steatosis by liver biopsy.

Objectives

To evaluate the concordance between abdominal ultrasound and CAP by TE for the diagnosis of LS.

Methods

Observational study. 160 patients (age 53 ± 14 years, 66.2% women) referred for TE (FibroScan; Echosens). The main indication was non-alcoholic fatty liver disease (44.4%). A cutoff of 233 dB / m was defined for the diagnosis of CAP steatosis and cuts recommended by the manufacturer were used for staging the grade of LS. Clinical data and reports of abdominal ultrasounds performed in the 90 days prior to the examination were recorded. Statistical analysis by proportion of agreement and kappa index.

Results

LS was diagnosed by ultrasound in 85 patients (53.1%) vs 92 patients (57.5%) by CAP. The proportion of concordance between both exams was 74.3%, with a kappa index of 0.529. In patients with LS diagnosed by CAP, 73.9% had a concordant diagnosis by ultrasound, increasing to 82.4% when considering only patients with moderate and severe LS by CAP.

Conclusion

There is moderate concordance between CAP and ultrasound for the diagnosis of LS, which increases in moderate and severe steatosis. The CAP could be an alternative tool for the diagnosis of LS, with eventual greater precision in mild cases.