Ultrasonographic scoring system score versus liver stiffness measurement in prediction of cirrhosis.

Kyoung Min Moon, Gaeun Kim, Soonkoo Baik, Eunhee Choi, Moonyoung Kim, Hyoun A. Kim, Meeyon Cho, Seung Yong Shin, Jung Min Kim, Hong Jun Park, Sang Ok Kwon, Young Woo Eom

Research output: Contribution to journalArticle

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Abstract

We compared the cirrhosis-prediction accuracy of an ultrasonographic scoring system (USSS) combining six representative sonographic indices with that of liver stiffness measurement (LSM) by transient elastography, and prospectively investigated the correlation between the USSS score and LSM in predicting cirrhosis. Two hundred and thirty patients with chronic liver diseases (187 men, 43 women; age, 50.4±9.5 y, mean±SD) were enrolled in this prospective study. The USSS produces a combined score for nodularity of the liver surface and edge, parenchyma echogenicity, presence of right-lobe atrophy, spleen size, splenic vein diameter, and abnormality of the hepatic vein waveform. The correlations of the USSS score and LSM with that of a pathological liver biopsy (METAVIR scoring system: F0-F4) were evaluated. The mean USSS score and LSM were 7.2 and 38.0 kPa, respectively, in patients with histologically overt cirrhosis (F4, P=0.017) and 4.3 and 22.1 kPa in patients with fibrotic change without overt cirrhosis (F0-F3) (P=0.025). The areas under the receiver operating characteristic (ROC) curves of the USSS score and LSM for F4 patients were 0.849 and 0.729, respectively. On the basis of ROC curves, criteria of USSS ≥6: LSM ≥17.4 had a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 89.2%:77.6%, 69.4%:61.4%, 86.5%:83.7%, 74.6%:51.9% and 0.83:0.73, respectively, in predicting F4. The results indicate that this USSS has comparable efficacy to LSM in the diagnosis of cirrhosis.

Original languageEnglish
Pages (from-to)389-398
Number of pages10
JournalClinical and Molecular Hepatology
Volume19
Issue number4
DOIs
Publication statusPublished - 2013 Jan 1

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Fibrosis
Liver
ROC Curve
Splenic Vein
Elasticity Imaging Techniques
Hepatic Veins
Atrophy
Liver Diseases
Chronic Disease
Spleen
Prospective Studies
Biopsy
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Molecular Biology

Cite this

Moon, Kyoung Min ; Kim, Gaeun ; Baik, Soonkoo ; Choi, Eunhee ; Kim, Moonyoung ; Kim, Hyoun A. ; Cho, Meeyon ; Shin, Seung Yong ; Kim, Jung Min ; Park, Hong Jun ; Kwon, Sang Ok ; Eom, Young Woo. / Ultrasonographic scoring system score versus liver stiffness measurement in prediction of cirrhosis. In: Clinical and Molecular Hepatology. 2013 ; Vol. 19, No. 4. pp. 389-398.
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abstract = "We compared the cirrhosis-prediction accuracy of an ultrasonographic scoring system (USSS) combining six representative sonographic indices with that of liver stiffness measurement (LSM) by transient elastography, and prospectively investigated the correlation between the USSS score and LSM in predicting cirrhosis. Two hundred and thirty patients with chronic liver diseases (187 men, 43 women; age, 50.4±9.5 y, mean±SD) were enrolled in this prospective study. The USSS produces a combined score for nodularity of the liver surface and edge, parenchyma echogenicity, presence of right-lobe atrophy, spleen size, splenic vein diameter, and abnormality of the hepatic vein waveform. The correlations of the USSS score and LSM with that of a pathological liver biopsy (METAVIR scoring system: F0-F4) were evaluated. The mean USSS score and LSM were 7.2 and 38.0 kPa, respectively, in patients with histologically overt cirrhosis (F4, P=0.017) and 4.3 and 22.1 kPa in patients with fibrotic change without overt cirrhosis (F0-F3) (P=0.025). The areas under the receiver operating characteristic (ROC) curves of the USSS score and LSM for F4 patients were 0.849 and 0.729, respectively. On the basis of ROC curves, criteria of USSS ≥6: LSM ≥17.4 had a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 89.2{\%}:77.6{\%}, 69.4{\%}:61.4{\%}, 86.5{\%}:83.7{\%}, 74.6{\%}:51.9{\%} and 0.83:0.73, respectively, in predicting F4. The results indicate that this USSS has comparable efficacy to LSM in the diagnosis of cirrhosis.",
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Ultrasonographic scoring system score versus liver stiffness measurement in prediction of cirrhosis. / Moon, Kyoung Min; Kim, Gaeun; Baik, Soonkoo; Choi, Eunhee; Kim, Moonyoung; Kim, Hyoun A.; Cho, Meeyon; Shin, Seung Yong; Kim, Jung Min; Park, Hong Jun; Kwon, Sang Ok; Eom, Young Woo.

In: Clinical and Molecular Hepatology, Vol. 19, No. 4, 01.01.2013, p. 389-398.

Research output: Contribution to journalArticle

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T1 - Ultrasonographic scoring system score versus liver stiffness measurement in prediction of cirrhosis.

AU - Moon, Kyoung Min

AU - Kim, Gaeun

AU - Baik, Soonkoo

AU - Choi, Eunhee

AU - Kim, Moonyoung

AU - Kim, Hyoun A.

AU - Cho, Meeyon

AU - Shin, Seung Yong

AU - Kim, Jung Min

AU - Park, Hong Jun

AU - Kwon, Sang Ok

AU - Eom, Young Woo

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N2 - We compared the cirrhosis-prediction accuracy of an ultrasonographic scoring system (USSS) combining six representative sonographic indices with that of liver stiffness measurement (LSM) by transient elastography, and prospectively investigated the correlation between the USSS score and LSM in predicting cirrhosis. Two hundred and thirty patients with chronic liver diseases (187 men, 43 women; age, 50.4±9.5 y, mean±SD) were enrolled in this prospective study. The USSS produces a combined score for nodularity of the liver surface and edge, parenchyma echogenicity, presence of right-lobe atrophy, spleen size, splenic vein diameter, and abnormality of the hepatic vein waveform. The correlations of the USSS score and LSM with that of a pathological liver biopsy (METAVIR scoring system: F0-F4) were evaluated. The mean USSS score and LSM were 7.2 and 38.0 kPa, respectively, in patients with histologically overt cirrhosis (F4, P=0.017) and 4.3 and 22.1 kPa in patients with fibrotic change without overt cirrhosis (F0-F3) (P=0.025). The areas under the receiver operating characteristic (ROC) curves of the USSS score and LSM for F4 patients were 0.849 and 0.729, respectively. On the basis of ROC curves, criteria of USSS ≥6: LSM ≥17.4 had a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 89.2%:77.6%, 69.4%:61.4%, 86.5%:83.7%, 74.6%:51.9% and 0.83:0.73, respectively, in predicting F4. The results indicate that this USSS has comparable efficacy to LSM in the diagnosis of cirrhosis.

AB - We compared the cirrhosis-prediction accuracy of an ultrasonographic scoring system (USSS) combining six representative sonographic indices with that of liver stiffness measurement (LSM) by transient elastography, and prospectively investigated the correlation between the USSS score and LSM in predicting cirrhosis. Two hundred and thirty patients with chronic liver diseases (187 men, 43 women; age, 50.4±9.5 y, mean±SD) were enrolled in this prospective study. The USSS produces a combined score for nodularity of the liver surface and edge, parenchyma echogenicity, presence of right-lobe atrophy, spleen size, splenic vein diameter, and abnormality of the hepatic vein waveform. The correlations of the USSS score and LSM with that of a pathological liver biopsy (METAVIR scoring system: F0-F4) were evaluated. The mean USSS score and LSM were 7.2 and 38.0 kPa, respectively, in patients with histologically overt cirrhosis (F4, P=0.017) and 4.3 and 22.1 kPa in patients with fibrotic change without overt cirrhosis (F0-F3) (P=0.025). The areas under the receiver operating characteristic (ROC) curves of the USSS score and LSM for F4 patients were 0.849 and 0.729, respectively. On the basis of ROC curves, criteria of USSS ≥6: LSM ≥17.4 had a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 89.2%:77.6%, 69.4%:61.4%, 86.5%:83.7%, 74.6%:51.9% and 0.83:0.73, respectively, in predicting F4. The results indicate that this USSS has comparable efficacy to LSM in the diagnosis of cirrhosis.

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