Effect Of Liver Stiffness ( Ls ) Measured By Vibration Controlled Transient Elastography ( Vcte )

Effect Of Liver Stiffness ( Ls ) Measured By Vibration Controlled Transient Elastography ( Vcte )

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Liver stiffness (LS) measured by vibration controlled transient elastography (VCTE) correlates with histologic stages of fibrosis in primary sclerosing cholangitis (PSC). Compared to liver biopsy or VCTE, magnetic resonance elastography (MRE) samples a larger cross-sectional area and may improve fibrosis assessment in PSC where the disease process is distributed unevenly. LS measured by MRE (MRE LS) in PSC patients was assessed in univariate and multivariate analysis to identify factors associated with MRE LS and to compare its accuracy with Model for End-Stage Liver Disease (MELD) score and Mayo Risk Score (MRS) in predicting hepatic decompensation or liver transplant (LT) listing. MRE was measured in 69 PSC patients with typical features of the disease; median age 49.0 ±15.7 (19 – 82), 58% male, 86.2% white, 73.5% with inflammatory bowel disease (IBD) and mean PSC disease duration of 9.1 ± 4.5 (0.69 – 26.0) years. MRE LS correlated significantly with MELD, MRS, platelet count (PLT), alkaline phosphatase (ALP) level, hepatic decompensation, and LT listing. In a multivariate linear regression analysis, hepatic decompensation (p=0.0004), LT listing (p=0.002), PLT count (p=0.006), ALP >upper limit of normal (ULN) (p=0.03) and body mass index (BMI) (p=0.03) were independent predictors of MRE LS. The area under the receiver-operator curve (AUROC) for MRE in identifying hepatic decompensation or LT listing (0.95) was superior to MELD (0.81) or MRS (0.88). These results suggest that MRE LS may be a valid biomarker for clinical trials and in the clinical assessment of PSC patients.



Background
Primary sclerosing cholangitis (PSC) is a chronic cholestatic disease of the liver and bile ducts of unknown cause that is often progressive an...


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