Aim: To describe the two-dimensional elastographic profile according to the Shearwave (2D-SWE) technique in patients with chronic liver disease in Lomé. Materials and method: Cross-sectional, descriptive study conducted over seven month at the Autel d’Elie Clinic in Lomé, from January to August 2022, on adult patients with chronic liver disease who underwent abdominal ultrasound coupled with two-dimensional elastography. Results: The sample size was 54 patients. The mean age of the patients was 33 ± 12 years, with extremes of 18 and 66 years. Patients aged 30 years or less accounted for 48.1% (n = 26). All patients (n = 54) had at least one transaminase assay with a mean of 69.3 ± 78.3 IU/l (AST) and 59.3 ± 82.8 IU/l (ALT). There was no statistically significant association between the biological parameters and the presence of fibrosis. Viral liver disease was the main cause, accounting for 81.5% (n = 44) of cases, with no significant association with the degree of fibrosis. Ultrasound revealed a dysmorphic liver (57.4%; n = 31) and portal hypertension (18.5%, n = 10). Fibrosis stages F1, F2 and F4 accounted for (48.1%, n = 26), (24.1%, n = 13) and (13%, n = 7) of cases respectively. Liver dysmorphia was significantly associated with the presence of fibrosis (p = 0.012) and portal hypertension was significantly associated with the degree of fibrosis (p = 0.0063). Conclusion: Assessment of liver fibrosis in patients with chronic liver disease using 2D-SWE elastography is essential for patient follow-up.
References
[1]
Bourliere, M. (2005) How to Assess Hepatic Fibrosis Outside of PBH. Paris, 135-148. https://www.fmcgastro.org/postu-main/archives/postu-2005-paris/comment-evaluer-la-fibrose-hepatique-en-dehors-de-la-pbh
[2]
Aydin, M.M. and Akcali, K.C. (2018) Liver Fibrosis. Turkish Journal of Gastroenterology, 29, 14-21. https://pubmed.ncbi.nlm.nih.gov/29391303/ https://doi.org/10.5152/tjg.2018.17330
[3]
Office, C. (2010) Assessing Fibrosis: Why? Why? Pour qui? FMC-HGE, 245-258. https://www.fmcgastro.org/postu-main/archives/postu-2010-paris/evaluer-la-fibrose-pourquoi-comment-pour-qui-2/
[4]
Sharma, S., Khalili, K. and Nguyen, G.C. (2014) Non-Invasive Diagnosis of Advanced Fibrosis and Cirrhosis. World Journal of Gastroenterology, 20, 16820-16830. https://doi.org/10.3748/wjg.v20.i45.16820
[5]
Soresi, M., Giannitrapani, L., Cervello, M., Licata, A. and Montalto, G. (2014) Non Invasive Tools for the Diagnosis of Liver Cirrhosis. World Journal of Gastroenterology, 20, 18131-18150. https://doi.org/10.3748/wjg.v20.i48.18131
[6]
Lawson-Ananissoh, L., Bagny, A., Bouglouga, O., Kaaga, L., Namdiro, G., Yakoubou, R., et al. (2022) Evaluation of Hepatic Fibrosis in Patients with Chronic Hepatitis B Virus by Non-Invasive Methods: Aspartate-to-Platelet Ratio Index, Fibrosis-4, Fibrotest and Fibroscan. World Journal of Advanced Research and Reviews, 13, 172-179. https://doi.org/10.30574/wjarr.2022.13.1.0767
[7]
N’guyen-Khac, E. (2007) Results and Place of Fibroscan® in the Non-Invasive Diagnosis of Hepatic Fibrosis. La Revue de Médecine Interne, 28, 94-102. https://doi.org/10.1016/j.revmed.2006.10.329
[8]
Herman, E., de Lédinghen, V., Cassinotto, C., Chu, W.C.-W., Leung, V.Y.-F., Ferraioli, G., et al. (2018) Assessment of Biopsy-Proven Liver Fibrosis by Two-Dimensional Shear Wave Elastography: An Individual Patient Data-Based Meta-Analysis, Hepatology, 67, 260-272. https://doi.org/10.1002/hep.29179
[9]
Olariu, M.C., Stoichitoiu, E.L., Nurciu, A., Andriescu, G., Olariu, M.H. and Diaconu, C.C. (2019) The Role of Shear Wave Elastography in the Dynamic Monitoring of Fibrosis in Patients with Chronic Hepatitis C with Sustained Virological Response after Direct Acting Antiviral Therapy. Archives of the Balkan Medical Union, 54, 699-704. https://doi.org/10.31688/ABMU.2019.54.4.12
[10]
Rehm, J., Taylor, B., Mohapatra, S., et al. (2010) Alcohol as a Risk Factor for Liver Cirrhosis: A Systematic Review and Meta-Analysis. Drug and Alcohol Review, 29, 437-445. https://doi.org/10.1111/j.1465-3362.2009.00153.x
[11]
EASL (2018) Clinical Practice Guidelines: Management of Alcohol-Related Liver Disease. Journal of Hepatology, 69, 154-181. https://doi.org/10.1016/j.jhep.2018.03.018
[12]
Billiard, J.-S., Olivié, D. and Tang, A. (2010) Ascites, Peritoneal Collections and Non-Tumoral Peritoneum. In: Nahum, H., Vilgrain, V. and Régent, D. Eds., Imagerie de l’abdomen, Lavoisier, Paris, 655-669.
[13]
Denys, A. and Lafortune, M. (2010) Portal Hypertension: Diagnostic Imaging. In: Nahum, H., Vilgrain, V. and Régent, D. Eds., Imagerie de l’abdomen, Lavoisier, Paris, 146-165.
[14]
Taourel, P., Blanc, P., Dauzat, M., Chabre, M., Pradel, J., Gallix, B., et al. (1998) Doppler Study of Mesenteric Hepatic and Portal Circulation in Alcoholic Cirrhosis: Relation-Ship between Quantitative Doppler Measurements and the Severity of Portal Hypertension and Hepatic Failure. Hepatology, 28, 932-936. https://doi.org/10.1002/hep.510280406
[15]
Dietrich, C.F., Bamber, J., Berzigotti, A., Bota, S., Cantisani, V., Castera, L., et al. (2017) EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Long Version). Ultraschall in der Medizin, 38, e16-e47. https://pubmed.ncbi.nlm.nih.gov/28407655/ https://doi.org/10.1055/s-0043-103952
[16]
Sehonou, J., Kodjoh, N., Sake, K. and Mouala, C. (2010) Cirrhosis of the Liver in Cotonou (Republic of Benin): Clinical Aspects and Factors Associated with Death. Tropical Medicine, 70, 375-378.
[17]
Kolou, M., Nadjir, L.K., Anyovi, F., Katawa, G., Abaltou, B. and Salou, M. (2018) Seroprevalence of Viral Hepatitis B and C in the General Population of Lomé. Journal de la Recherche Scientifique de l’Université de Lomé, 20, 225-233.
[18]
Haute Autorité de Santé (2008) Critères diagnostiques et bilan initial de la cirrhose non compliquée. https://www.has-sante.fr/upload/docs/application/pdf/diagnostic_cirrhose_-_recommandations.pdf
[19]
Xie, X., Feng, Y., Lyu, Z., Wang, L., Yang, Y., Bai, Y., et al. (2020) Liver Stiffness as Measured by Two-Dimensional Shear Wave Elastography Overestimates the Stage of Fibrosis in Patients with Chronic Hepatitis B and Hepatic Steatosis. Clinics and Research in Hepatology and Gastroenterology, 45, Article 101421. https://doi.org/10.1016/j.clinre.2020.03.021
[20]
Aubé, C. (2010) Cirrhosis and Its Complications. In: Nahum, H., Vilgrain, V. and Régent, D. Eds., Imagerie de l’abdomen, Lavoisier, Paris, 130-145.
[21]
Liu, J., Ma, Y., Han, P., Wang, J., Liu, Y.G., Shi, R.F., et al. (2022) Hepatic Steatosis Leads to Overestimation of Liver Stiffness Measurement in Both Chronic Hepatitis B and Metabolic-Associated Fatty Liver Disease Patients. Clinics and Research in Hepatology and Gastroenterology, 46, Article 101957. https://doi.org/10.1016/j.clinre.2022.101957
[22]
Kumada, T., Toyoda, H., Yasuda, S., Ogawa, S., Gotoh, T., Ito, T., et al. (2022) Liver Stiffness Measurements by 2D Shear-Wave Elastography: Effect of Steatosis on Fibrosis Evaluation. American Journal of Roentgenology, 219, 604-613. https://pubmed.ncbi.nlm.nih.gov/35506556/ https://doi.org/10.2214/AJR.22.27656
[23]
Olteanu, V.A., Balan, G.G., Timofte, O., Dascalu, C.G., Gologan, E., Gilca-Blanariu, G.E., et al. (2022) Risk Predictors of Advanced Fibrosis in Non-Alcoholic Fatty Liver Disease. Diagnostics, 12, Article 2136. https://pubmed.ncbi.nlm.nih.gov/36140537/ https://doi.org/10.3390/diagnostics12092136
[24]
Ye, J., Wang, W., Feng, S., Huang, Y., Liao, X., Kuang, M., et al. (2020) Precise Fibrosis Staging with Shear Wave Elastography in Chronic Hepatitis B Depends on Liver Inflammation and Steatosis. Hepatology International, 14, 190-201. https://pubmed.ncbi.nlm.nih.gov/32078141/ https://doi.org/10.1007/s12072-020-10017-1
[25]
Chimoriya, R., Piya, M.K., Simmons, D., Ahlenstiel, G. and Ho, V. (2020) The Use of Two-Dimensional Shear Wave Elastography in People with Obesity for the Assessment of Liver Fibrosis in Non-Alcoholic Fatty Liver Disease. Journal of Clinical Medicine, 10, Article 95. https://pubmed.ncbi.nlm.nih.gov/33383965/ https://doi.org/10.3390/jcm10010095
