P-67 ULTRASOUND GUIDED TRANSIENT ELASTOGRAPHY FOR THE DIAGNOSIS AND STAGING OF LIVER FIBROSIS

Introduction

Transient elastography (TE) is a non-invasive method for the evaluation of liver fibrosis. Up to 20% of measurements fail, possibly due to the choice of probe position.

Objectives

To evaluate the use of ultrasound as a position guide (UPG) prior to TE to improve the measurement of liver stiffness (LS).

Methods

Prospective study of 237 patients (age 54 ± 14 years, 69% women) referred for TE (FibroScan, Echosens). The main indication was non-alcoholic fatty liver disease (52.3%). 65.4% of the patients were overweight or obese. LS was measured in each patient according to the manufacturer's recommendations and at the same appointment, in UPG. Fibrosis staging sections recommended by the manufacturer were used. Statistical analyzes performed with chi-square and t-test (p <0.05).

Results

The mean LS with UPG was 7.6 (3.0-55.7) kPa. In 50 patients (21.1%) the measurement of LS failed without the use of ultrasound. There was not when using UPG. In the 187 patients with TE without ultrasound, IQR / LSM <10% was obtained in 67.3%. When UPG was used, it was obtained in 89% (p = 0.001). When comparing the fibrosis stage, in 21.4% of the cases it was modified when using UPG; in 15% it changed from significant or advanced fibrosis (F2-F4) to non-significant (F0-F1), or vice versa.

Conclusion

The use of UPG before TE improved the success rate and reliability of the LS measurement, improving fibrosis staging.