Diagnosis and Staging of Hepatic Fibrosis by Ultrasound Elastography in Patients with Chronic Liver Diseases

Abstract

The progressive hepatic fibrosis with the development of cirrhosis is a feature of almost all chronic liver diseases. Approximately 10–20% of patients with chronic hepatitis C virus infection have cirrhosis at first clinical presentation, and as many 20–30% of those who do not have cirrhosis will eventually develop this condition and its complications within one or more decades. These complications are liver failure, ascites, variceal bleeding, portosystemic encephalopathy, and hepatocellular carcinoma (Foucher J et al., 2005). Until recently, liver biopsy (LB) examination was the only way of evaluating liver fibrosis. However, LB examination is invasive and painful, and can have life-threatening complications. The poor acceptability of LB examination can lead to treatment delays, and LB examination is difficult to repeat in poorly symptomatic subjects. The accuracy of LB examination for assessing fibrosis also has been questioned because of sampling errors, intra and interobserver variability that may lead to over or under staging of fibrosis. There is thus a need for accurate non-invasive methods of measuring the degree of liver fibrosis. Proposed approaches include physical examination, routine biochemical and hematologic tests, surrogate serum fibrosis markers have been used (Castera L, 2005).