The diagnostic value of ARFI imaging and APRI for quantitative evaluating the degree of liver fibrosis in NAFLD patients

Objective: To investigate the diagnostic value of the acoustic radiation force impulse(ARFI) imaging technology and AST/PLT ratio index(APRI) for the assessment of the liver fibrosis in NAFLD patients.Methods: Sixty-seven patients with non-alcoholic fatty liver disease(NAFLD) were included,the subjects were underwent liver biopsy,liver function,blood count,as well as real-time ultrasonic elastography examination.The measurements of real-time ultrasonic elastography by ARFI technology using a ultrasonic instrument ACUSON S2000.The APRI was calculated according to the following formula,APRI=AST(ULN)/PLT(109 /L).ARFI and APRI were compared by correlation with liver fibrosis stage in NAFLD.Referring to the histologic fibrosis stage on liver biopsy,all the ARFI and the APRI value were assessed by using receiver operating characteristic(ROC) curve analysis.The corresponding cut-off values,sensitivity and specificity were also calculated and compared.Results: The mean values of ARFI and APRI were(1.177±0.281) m/s and(0.192±0.155) for the patients with S0,(1.249±0.308) m/s and(0.190±0.097) for those with S1,(1.436±0.521) m/s and(0.306±0.195) for those with S2,(1.538±0.496) m/s and(0.224±0.094) for those with S3,(1.857±0.729) m/s and(0.373±0.295) for those with S4,respectively.ARFI(r=0.416,P0.01) had a better correlation with liver fibrosis stage in NAFLD than APRl(r=0.254,P0.05).The areas under the ROC curves(AUC) for ARFI and APRI were 0.714 and 0.653 for S≥2,0.765 and 0.577 for S≥3,0.853 and 0.611 for S=4,respectively.Conclusions: As a non-invasive technology,ARFI is more accurate when applied to evaluate liver fibrosis in patients with NAFLD than APRI.ARFI technology has potential value for quantitative evaluation of the liver fibrosis for NAFLD.