Diagnostic Accuracy of ARFI Elastography in Differentiating Non-Cirrhotic Portal Fibrosis from Cirrhotic Portal Hypertension

Abstract

Background: Differentiating Non-Cirrhotic Portal Fibrosis (NCPF) from Cirrhotic Portal Hypertension (CPH) is crucial for appropriate management and prognostication. Acoustic Radiation Force Impulse (ARFI) elastography has emerged as a non-invasive modality for assessing liver stiffness, which may aid in this differentiation.

Objective: To evaluate the diagnostic accuracy of ARFI elastography in distinguishing NCPF from CPH.

Methods: This Cross-sectional study was conducted among 30 patients with clinically and radiologically suspected portal hypertension who underwent ARFI elastography. Liver stiffness measurements (LSM) obtained via ARFI were compared between patients with NCPF and those with CPH, confirmed by clinical, biochemical, and histopathological findings with Liver biopsy where available. Sensitivity, Specificity, PPV and NPV were performed to assess the diagnostic Accuracy of ARFI in differentiating the two conditions.

Results: A total of 30 patients were included, with 12 diagnosed with NCPF and 18 with Cirrhosis with Portal Hypertension. ARFI predicted diagnostic accuracy with Combined LS, SS and SS/LS demonstrated a sensitivity of 83.3%, specificity of 27.8% for NCPF and sensitivity of 72.2%, specificity of 16.7% for Cirrhosis with Portal hypertension.

Conclusion: ARFI elastography is a useful non-invasive tool with good diagnostic accuracy in differentiating NCPF from CPH, potentially reducing the need for invasive procedures such as liver biopsy in selected patients.