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Diomidova V.N., Valeeva O.V., Vasilyeva L.N.
Two-dimensional elastography and shear wave elastometry in assessing liver fibrosis progression factors in chronic viral hepatitis C
Keywords: ultrasound diagnostics, elastography and shear wave elastometry, liver fibrosis, clinical and laboratory diagnostics, chronic hepatitis C
Chronic viral hepatitis C is characterized by progressive liver fibrosis, which ultimately determines the prognosis of the disease. On the back of this, identifying informative predictors of fibrogenesis in this category of patients remains an urgent task necessary to optimize the risk stratification of liver cirrhosis development and improve monitoring of the course of the disease. The aim of the study was to evaluate the factors associated with liver fibrosis progression in patients with chronic viral hepatitis C, according to ultrasound two–dimensional elastography and shear wave elastometry in comparison with clinical and laboratory parameters. Materials and methods. A single-center analysis of 120 patients aged 52.4±11.3 years (66 men and 54 women) was performed. Three groups were formed: the main group N1 (n = 50) – patients with chronic viral hepatitis C; comparison group N2 (n = 28) – patients with non-alcoholic fatty liver disease; control group N3 (n = 42) – practically healthy individuals, comparable in gender and age (p < 0.05). All the participants underwent ultrasonic shear wave elastometry on a Mindray RESONA 7 device (China) with an assessment of the stage (F0-F4) and quantitative indicators of liver stiffness. Additionally, metabolic (body mass index, obesity, metabolic syndrome, and steatosis), biochemical (transaminase activity, markers of the liver function, cholestasis, and systemic inflammation), and hematological (leukocyte, erythrocyte and platelet levels) parameters were analyzed. The dynamic observation period lasted 18 months. The Kruskal–Wallis test was used for statistical analysis. Results. Elastometry data revealed significant differences in median liver stiffness values between all stages of fibrosis (F0–F4) in patients with chronic viral hepatitis C. A close relationship between quantitative values and the severity of fibrous transformation was established. The study of metabolic factors did not show statistically significant intergroup differences in body mass index depending on the stage of liver fibrosis (p = 0.101). Based on the results of biochemical indicators in patients with chronic viral hepatitis C, statistically significant differences in gamma-glutamyltransferase activity were recorded between groups with different stages of fibrosis (p = 0.019). For alkaline phosphatase, the intergroup differences did not reach statistical significance (p = 0.073). Analysis of haematological parameters in patients with chronic viral hepatitis C revealed no statistically significant differences in white blood cell and red blood cell counts (p > 0.05) but significant differences in platelet levels were found (p = 0.008), and a clear inverse correlation between the stage of fibrosis and the number of platelets in the blood was identified. Conclusions. The data obtained provide convincing evidence of a high diagnostic value of shear wave ultrasound elastometry for non-invasive assessment of liver fibrosis stages in patients with chronic viral hepatitis C. The method demonstrates high accuracy in differentiating fibrosis stages and a strong correlation with the histological standard, expressed in quantitative indicators of liver stiffness. The identified inverse correlation between platelet count and fibrosis stage confirms its role as a significant non-invasive marker of disease progression. Based on the results of the study, the shear wave elastometry method can be recommended for routine use in clinical practice for dynamic monitoring and risk stratification in patients with chronic viral hepatitis C.
References
- Zhirkov I.I., Gordienko A.V., Pavlovich I.M. et al. Diagnostika fibroza pecheni: aktsent na elastografiyu [Diagnosis of Liver Fibrosis: Emphasis on Elastography]. Eksperimental‘naya i klinicheskaya gastroenterologiya, 2021, no. 194(10), pp. 72–81. DOI: 10.31146/1682-8658-ecg-194-10-72-81.
- Serkova M.Yu., Skvortsova T.E., Bakulin I.G. Diagnosticheskie vozmozhnosti metoda elastografii i steatometrii sdvigovoi volny u patsientov s nealkogol‘noi zhirovoi bolezn‘yu pecheni [Diagnostic capabilities of the shear wave elastography and steatometry method in patients with non-alcoholic fatty liver disease]. Eksperimental‘naya i klinicheskaya gastroenterologiya, 2020, no.184(12), pp. 49–52. DOI: 10.31146/1682-8658-ecg-184-12-49-52.
- Minnemullin I.M., Mukhametova D.D., Kormilina A.R. et al. Ul’trazvukovaya elastometriya v otsenke tyazhesti fibroza pri khronicheskikh zabolevaniyakh pecheni [Ultrasonic elastometry in assessing the severity of fibrosis in chronic liver diseases]. Prakticheskaya meditsina, 2022, vol. 20, no. 6, pp. 64–70.
- Izranov V.A., Kazantseva N.V., Stepanyan I.A. et al. Elastografiya sdvigovoi volnoi pecheni: problema tochnosti i vosproizvodimosti [Diagnosis of Liver Fibrosis: Emphasis on Elastography]. Vestnik Baltiiskogo federal‘nogo universiteta im. I. Kanta. Ser. Estestvennye i meditsinskie nauki, 2020, no. 2, pp. 67–88.
- Chimoriya R., Ho V., Wang Z.V. et al. Application and Diagnostic Performance of Two-Dimensional Shear Wave Elastography and Liver Fibrosis Scores in Adults with Class 3 Obesity. Nutrients., 2023, vol. 16, no. 1, p. 74. DOI: 10.3390/nu16010074.
- Ferraioli G. Review of Liver Elastography Guidelines. Journal of Ultrasound in Medicine, 2019, vol. 38, no. 1, pp. 9–14. DOI: 10.1002/jum.14856.
- Ferraioli G., Wong V., Castera L. et al. Liver Ultrasound Elastography: An Update to the WFUMB Guidelines and Recommendations. Ultrasound in Medicine and Biology, 2018, vol. 44, no. 12, pp. 2419–2440. DOI: 10.1016/j.ultrasmedbio.2018.07.008.
- Furlan A., Tublin M.E., Yu L. et al. Comparison of 2D Shear Wave Elastography, Transient Elastography, and MR Elastography for the Diagnosis of Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. American Journal of Roentgenology, 2020, vol. 214, no. 1, pp. W20–W26. DOI: 10.2214/AJR.19.21267.
- Herrmann E., de Lédinghen V., Cassinotto C. et al. Assessment of biopsy-proven liver fibrosis by two-dimensional shear wave elastography: An individual patient data-based meta-analysis. Hepatology, 2018, vol. 67, no. 1, pp. 260–272. DOI: 10.1002/hep.29179.
- Indre M.G., Leucuta D.C., Lupsor-Platon M. et al. Diagnostic accuracy of 2D-SWE ultrasound for liver fibrosis assessment in MASLD: A multilevel random effects model meta-analysis. Hepatology, 2025, vol. 82, no. 2, pp. 454–469. DOI: 10.1097/HEP.0000000000001190.
- Li Q., Gao Y., Wang D. et al. Prospective Comparison of 2D-Shear Wave Elastography and Vibration-Controlled Transient Elastography in Assessing Liver Fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease. Academic Radiology, 2025, vol. 32, no. 9, pp. 5100–5111. DOI: 10.1016/j.acra.2025.04.009.
- Liu J.H., Zou Y., Chang W. et al. Assessment of Liver Fibrosis Using Real-time Shear-wave Elastography for Patients with Hepatitis B e Antigen-negative Chronic Hepatitis B and Alanine Transaminase <2 Times the Upper Limit of Normal. Revista de Investigación Clínica, 2017, vol. 69, no. 5, pp. 254–261. DOI: 10.24875/RIC.17002215.
- Park H.S., Choe W.H., Han H.S. et al. Assessing significant fibrosis using imaging-based elastography in chronic hepatitis B patients: Pilot study. World Journal of Gastroenterology, 2019, vol. 25, no. 25, pp. 3256–3267. DOI: 10.3748/wjg.v25.i25.3256.
- Singh S., Muir A.J., Dieterich D.T. et al. American Gastroenterological Association Institute Technical Review on the Role of Elastography in Chronic Liver Diseases. Gastroenterology, 2017, vol. 152, no. 6, pp. 1544–1577. DOI: 10.1053/j.gastro.2017.03.016.
- Yang A.H., Yardeni D., Hercun J. et al. Shear wave elastography: How well does it perform in chronic hepatitis D virus infection? Journal of Viral Hepatitis, 2022, vol. 29, no. 12, pp. 1127–1133. DOI: 10.1111/jvh.13745.
About authors
- Diomidova Valentina N.
- Doctor of Medical Sciences, Professor, Head of the Department of Propaedeutics of Internal Diseases with a Course of Radiation Diagnostics, Chuvash State University; Head of the Department of Ultrasound Diagnostics, City Clinical Hospital № 1, Russia, Cheboksary (diomidovavn@rambler.ru; ORCID: https://orcid.org/0000-0002-3627-7971)
- Valeeva Olga V.
- Candidate of Medical Sciences, Associate Professor, Department of Propaedeutics of Internal Diseases with a Course of Radiation Diagnostics, Chuvash State University; Ultrasound Diagnostics Physician, City Clinical Hospital № 1, Russia, Cheboksary (valeeva-usd@mail.ru; ORCID: https://orcid.org/0000-0002-0349-1883)
- Vasilyeva Lidiya N.
- Senior Lecturer, Department of Propaedeutics of Internal Diseases with a Course of Radiation Diagnostics, Chuvash State University, Russia, Cheboksary (klni21@mail.ru; ORCID: https://orcid.org/0000-0002-3298-3051)
Article link
Diomidova V.N., Valeeva O.V., Vasilyeva L.N. Two-dimensional elastography and shear wave elastometry in assessing liver fibrosis progression factors in chronic viral hepatitis C [Electronic resource] // Acta medica Eurasica. – 2025. – №4. P. 1-14. – URL: https://acta-medica-eurasica.ru/en/single/2025/4/1/. DOI: 10.47026/2413-4864-2025-4-1-14.