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Factors Influencing Transient Elastography in Detecting Liver Stiffness

Anoop KV, Krishnadas Devadas and Jijo Varghese

Transient elastography (TEE) is a method used for estimating liver fibrosis by measuring the liver stiffness (LSM). Aim of this study was to investigate whether TEE fibrosis scores and liver biopsy fibrosis scores are comparable. It was a Cross sectional study of patients undergoing liver biopsy because of high TEE with persistent transaminitis/normal TEE with persistent transaminitis/high TEE with normal transaminases. TEE fibrosis score of study population was compared to liver biopsy fibrosis scores, which is considered as gold standard, and patients with discordance of more than one fibrosis stage was analyzed with above mentioned variables which can affect TEE. Characteristics of the discordant population was analysed. After applying spearmanˊs correlation it was found that albumin, Total bilirubin and INR had a strong correlation with TEE values. Multiple regression analysis showed albumin and SGOT were independent predictors of Liver stiffness measurement. The discordant population was again analysed after classifying it into two groups i.e F 0-2 (minimal fibrosis) and F 3 (significant fibrosis based on biopsy). After analysis it was found that in F 0-2 group there were certain variables like SGPT, Albumin and INR which had strong correlation with TEE values. Total bilirubin and platelets had moderate correlation with TEE values. After analysing F3 group, age had strong positive correlation with TEE values. TEE was found to be better in detecting liver stiffness than liver biopsy in clinically suspected cirrhosis in this study.