– Background: In early-stage cirrhosis, the liver functional reserve may be preserved or rapidly deteriorated. This unpredictable progression of cirrhosis is caused by the heterogeneous distribution of hepatic fibrosis, that can be assessed by Quantitative Acoustic Radiation Force Impulse (ARFI) Elastography. In our study, we evaluated if Quantitative ARFI could be predictive of the short-term clinical outcome of patients with compensated HCV-related Child-Pugh A liver cirrhosis.
– Patients and Methods: 46 patients with HCV-related Child A cirrhosis were submitted to Quantitative ARFI sampling on the right liver and underwent a 24-month clinical follow-up. The velocity of the shear waves (in m/s) in the liver tissue was collected and recorded from 20 different sites, and the median and interquartile range were calculated. We compared the clinical progression of patients whose first quartile (q1) of ARFI values was >2 m/s vs. <2 m/s.
– Results: At baseline, all patients had median liver stiffness >2 m/s. 27 patients (59%) had q1 values <2 m/s. Short-term clinical progression of cirrhosis was significantly associated with higher q1 values (OR 45.6, p=0.042). The number of patients who clinically progressed was higher in the group with q1 >2 m/s (63.2% vs. 11.1%, p=0.0003). In fact, 7.4% of patients with q1 <2 m/s progressed to Child-Pugh class B; in the group of subjects with q1 >2 m/s, 31.6% progressed from Child-Pugh class A to B and 5.7% from Child-Pugh class A to C. None of the patients with q1 <2 m/s died during the course of the 24-month follow-up vs. 15.8% of patients with q1 >2 m/s (p=0.032).
— Conclusions: A q1 value >2 m/s by quantitative ARFI may help to identify patients with compensated cirrhosis with reduced functional reserve and at higher risk for short-term clinical progression.