Multiparametric ultrasound evaluation of liver fibrosis, steatosis, and viscosity in patients with chronic liver disease

Iulia Minciuna, Madalina Taru, Andreea Fodor, Oana Nicoara Farcau, Petra Fischer, Corina Radu, Monica Lupsor-Platon, Horia Stefanescu, Bogdan Procopet


Aims: This study assessed the effectiveness of three ultrasound-based techniques (2D-SWE.PLUS, Att.PLUS, Vi.PLUS) for non-invasive evaluation of liver fibrosis, steatosis, and inflammation in chronic liver disease (CLD) patients.

Materials and methods: Involving 209 consecutive compensated CLD patients, the study compared these ultrasound methods from Aixplorer
with standard Vibration-controlled Transient Elastography (VCTE) and Controlled Attenuation Parameter (CAP) from Fibroscan, alongside non-invasive serological markers.

Results: High validity rates were observed in measurements: 99% for VCTE, 89% for 2D-SWE.PLUS/Vi.PLUS, and 96.6% for Att.PLUS. 2D-SWE.PLUS showed a strong correlation with VCTE (R=0.91) and excelled at a lower Stability Index (80%), with optimal cut-offs for moderate and severe fibrosis at 8 kPa and 10 kPa, respectively. 2D-SWE.PLUS was superior to Fib4, eLIFT, APRI, BARD, and NFS in detecting advanced CLD. Att.PLUS moderately correlated with CAP (R=0.47) for steatosis grades, while Viscosity was highly effective in identifying significant fibrosis (AUC=0.87) but less so for inflammation.

Conclusions: 2D-SWE.PLUS demonstrated superior diagnostic precision in liver fibrosis, exceeding other non-invasive markers. Att.PLUS was relatively accurate for liver steatosis, and viscosity more effectively indicated fibrosis stages than inflammation in CLD patients. 


Multiparametric assessment; fibrosis; steatosis; viscosity; ultrasound

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