Comparison of superb microvascular imaging and shear-wave elastography for assessing liver fibrosis in chronic hepatitis B.
Mesude Tosun , Hande Uslu
Kocaeli University Medical School, Kocaeli, Turkey
Corresponding Author: Mesude Tosun ,Tel: +905363882258, Fax: +90 262 303 70 01, Email:
Received: June 23, 2021;  Accepted: November 25, 2021.  Published online: November 25, 2021.
We aimed to investigate the effectiveness and applicability of superb microvascular imaging (SMI) in determining the degree of liver fibrosis noninvasively and to compare it with shear wave elastography (SWE).
A total of 98 consecutive patients with chronic hepatitis B who underwent ultrasound-guided needle biopsy were examined, using ultrasonography (US) in combination with SMI and SWE. The prediction performance of the two US techniques in staging liver fibrosis and inflammation was compared. The results were compared with the histological findings obtained from the liver biopsy, which was accepted as a reference. Intraobserver and interobserver reproducibility of SMI in vascularity scores were evaluated.
SWE values and SMI vascular scores were statistically significantly different between fibrotic stages (χ2(3) = 76.3, χ2(3) = 81.5, p < 0.001, respectively). SWE and SMI models significantly predicted the fibrotic stages separately and in addition, SMI scores alone predicted the fibrotic stages better compared to SWE values (50.1% for SWE, 63.5% for SMI, p<0.001). When we ran the model with both SMI scores and SWE values together, the model explained 73.2% of the changes in fibrotic stages. When other clinical and laboratory predictors were added to the model (81.5%, p<0.001),SWE values and SMI scores were still the main predictors of fibrotic stages.SWE and SMI were also applicable in predicting inflammatory grades (31%, 34%, and both SWE&SMI explained 37.7%, p<0.001).
It was concluded that both SWE and SMI had good diagnostic performance in determining the degree of liver fibrosis in patients with chronic hepatitis B.
Keywords: Liver fibrosis; Shear wave elastography; Superb microvascular imaging; Vascularity score; Chronic B-viral hepatitis
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