Three-dimensional microscopic quantitative ultrasound for evaluating hepatitis B related liver cirrhosis

Objective To evaluate the diagnosis value of 3D microscopic ultrasound sonography for hepatitis B related liver cirrhosis (LC) and liver function decompensation. Methods Total of 270 patients were admitted to the Fourth People’s Hospital of Qinghai Province from January 2016 to December 2017, which were divided into chronic hepatitis B group (102 cases), compensatory LC group (84 cases) and decompensation LC group (84 cases). 3D microscopic ultrasound sonography, 2D shear waved elastography (2D-SWE) and blood routine examination were performed on each patient. Aspartate aminotransferase-to-platelet ratio index (APRI) were calculated. 3D microscopic ultrasound sonography scores, 2D-SWE scores and APRI were compared among the three groups, respectively. Receptor operation curves were built to compare the predictive values of 3D microscopic ultrasound sonography scores, 2D-SWE scores and APRI for LC and for liver function decompensation of LC patients. Results The score of 3D microscopic ultrasound sonography and liver hardness among the three groups were significantly different (F = 313.52, 173.36; both P < 0.001). The area under receptor operation curve (AUROC) of 3D microscopic ultrasound sonography for predicting cirrhosis was 0.925 (95%CI: 0.885-0.965, P < 0.001); with the cut-off value of 11.5 scores, the sensitivity and specificity of 3D microscopic ultrasound sonography for predicting cirrhosis were 85.7% and 90.2%, respectively. The AUROC of 3D microscopic ultrasound sonography for predicting decompensated cirrhosis was 0.850 (95%CI: 0.795-0.905, P < 0.001). With the cut-off value of 16.5 scores, the sensitivity and specificity of 3D microscopic ultrasound sonography for predicting decompensated cirrhosis were 60.7% and 89.3%, respectively. Conclusions A quantitative diagnostic standard based on 3D microscopic ultrasound sonography was established in this study, which could be used in the auxiliary diagnosis of LC and liver function decompensation. Key words: Ultrasound sonography; Shear-wave elastography; Liver cirrhosis; Chronic hepatitis B