About 6 percent (2%-7%) of the world’ s population is chronically infected by the hepatitis B virus (HBV). The role of Fibroscan for fibrosis assessment in HBV patients has not been widely studied. The present study was designed for the assessment of hepatic fibrosis by Fibroscan in HBV positive patients. This is a cross-sectional study with two groups of case and control. According to the physical examination, lab data, abdominal ultrasound, and hepatitis viral load, the case group was categorized into three subgroups: inactive carrier, chronic hepatitis, and cirrhosis. The Control group was selected from a healthy population of 145 HBV patients, and 370 healthy persons entered the study. The case group included 35 inactive carriers, 63 chronic hepatitis B, and 47 cirrhotic patients, and their mean amount of fibrosis (measured by Fibroscan) was 6. 169 kpa, 7. 758 kpa, and 24. 0255 kpa, respectively. Also, the mean amount of fibrosis was 5. 5510 (SD=2. 43) in the control group. There was a statistically significant difference between cirrhotic patients and other groups (P<0. 001). Also, a strong association between viral load and fibrosis degree was observed in chronic hepatitis B patients (P<0. 001, R2=0. 7811). Fibroscan is a novel instrument for the estimation of the liver fibrotic stage in HBV cirrhotic patients.

There is now adequate evidence to indicate that liver fi­brosis is a dynamic rather than a static process and as effec­tive antiviral and other specific therapies became available, fibrosis and even cirrhosis could become reversible (1, 2). Effective and early therapy of viral and autoimmune hepa­titis could result in reversibility of cirrhosis in addition to clinical cure (1-3). Therefore, we urgently need to be able to follow the progression or regression of fibrosis in response to therapy in addition to initial assessment of fibrosis by liver biopsy. Liver biopsy which was first introduced in 1923 has been used widely in the diagnosis of liver diseases and is still the gold standard reference for the assessment of liver fibrosis during the course of chronic liver diseases (4, 5)….

Background: Accurate diagnosis of fatty liver is crucial for prognosis and treatment planning.Objectives: This study aimed to correlate liver Fibroscan results with shear wave elastography and liver enzyme levels in fatty liver patients. Methods: In a cross-sectional study, 80 fatty liver patients from Shahid Motahari Clinic in Shiraz was examined over six months. Diagnoses were made using Fibroscan (Echosense 500) and CAP scores, while the Hepatorenal Index was measured with shear wave elastography (Sypersonic, Aixplorer elit). Previous sonography reports were collected for correlation. Results: Patients’ average age was 50.91 years so that 45% were men, and 55% were women. About 78.8% diagnosed with fatty liver by ultrasound were also diagnosed by elastography (true positive). A weak, non-significant positive correlation was observed between the Ratio and CAP score (r = 0.18, P = 0.87). ALT predicted fatty liver by elastography with 83.6% sensitivity and 64.7% specificity. Few studies in Iran have explored elastography and Fibroscan correlation in fatty liver. Conclusions: Shear wave elastography is a valuable non-invasive technique for predicting fatty liver.

Background: The assessment of liver fibrosis is an important way for prediction of liver disease progression and patient's prognosis. Liver stiffness measurement (LSM) is strongly associated with stage of liver diseases. overestimation of liver fibrosis in heart failure has been reported. We would like to introduce a new leading cause of liver fibrosis overestimation by presentation of two cases.Case Presentation: one case with right lobe hemangioma has an overestimation of liver fibrosis. The result completely changed when Fibroscan was performed in patient’s left lobe. Interestingly, another case with left lobe hemangioma had overestimation of fibrosis in her left lobe but, right lob Fibroscan was normal.Conclusion: We found that liver hemangioma may leads to overestimation of liver stiffness and the correct inspection of liver echogenicity before any interpretation of high liver stiffness is recommended. We suggest that patient with higher level of Fibroscan score repeat it in other sides of the liver. Also, they should be evaluated by sonography for ruling out of possible confounders such as hepatic hemangioma.

Background: Transient elastography (TE) is a new modality for the diagnosis of liver fibrosis caused by various etiologies. This study was conducted to determine the accuracy of TE in detecting the different stages of liver fibrosis in non-alcoholic fatty liver disease (NAFLD) patients.Methods: MEDLINE/PubMed, Embase, Ovid, Cochrane Library, American College of Physicians (ACP) Journal Club, Google Scholar, Database of abstracts of Reviews of Effects, and Web of Science that evaluated the liver stiffness by means of TE and liver biopsy were enrolled in this systematic review and meta-analysis. Published articles were extracted from 2002 to March 2015.Results: A total of 7 articles from 114 papers were included which consisted of 698 patients. The results indicated that whenF ≥3, the outcomes were 93.7% (95% confidence interval (CI): 92-95.5), 91.1% (95% CI: 89-93.2), 82.4% (95% CI: 79.9-84.9), and 95.9% (95% CI: 94.4-97.4) for sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), respectively. With fibrosis stage ³4, it has reached the sensitivity of 96.2 % (95% CI: 94.5-97.8), a specificity of 92.2% (95% CI: 89.9-94.6), a PPV of 5.5% (95% CI: 51.2-59.8) and NPV of 98.5% (95% CI: 97.4-99.5).Conclusion: We concluded that as the pathological fibrosis increases, the sensitivity, specificity and NPV of TE in the diagnosis of fibrosis improves in NAFLD patients. TE can be considered as a unique alternative instead of liver biopsy in NAFLD patients and it has an important role in the exclusion of liver cirrhosis. More studies are required to confirm the results.

Background: Non-alcoholic fatty liver disease (NAFLD) is the second most common cause of liver transplantation in the United States, with a continuously growing prevalence. There are several non-invasive methods to detect liver fibrosis, which is defined as the accumulation of extracellular matrix proteins, particularly collagens. It is most commonly associated with chronic liver diseases, such as NAFLD. Objectives: This study aimed to investigate the concordance between transient elastography (TE) and shear wave elastography (SWE) for liver fibrosis staging and also to examine the congruence between the controlled attenuation parameter (CAP) and the B-mode hepatorenal ratio for hepatic steatosis grading in patients with NAFLD. Patients and Methods: In this cross-sectional study conducted during March 2018-2019, NAFLD patients, referred to the liver clinic of our center for the non-invasive assessment of hepatic fibrosis, were enrolled. However, patients with sonographic features of cirrhosis, multiple hepatic masses, or moderate to large ascites were excluded,also, patients who were uncooperative during the tests were excluded. Measurements obtained by different tools were recorded. Kolmogorov-Smirnov test, Chi-square test, independent t-test, or Mann-Whitney tests, as well as Pearson’, s correlation coefficient test, were used to analyze the data. Results: Sixty-five patients (male-to-female ratio, 1: 13), with a median age of 47 years, were included in the study. The tools for assessing fibrosis (r = 0. 9538, 95% CI: 0. 9252-0. 9717, P < 0. 0001) and steatosis (r = 0. 429, 95% CI: 0. 2048-0. 6104, P < 0. 0001) were perfectly and moderately correlated, respectively. Sex, age, and body mass index (BMI) did not affect the results. Conclusion: The two elastography modalities showed a strong correlation for fibrosis staging in our study population. Also, the CAP and B-mode hepatorenal ratio were moderately correlated for grading hepatosteatosis. Overall, selection of the best assessment method among the studied modalities depends on factors other than internal validity.

Background: Nonalcoholic fatty liver disease (NAFLD) is being increasingly recognized as a cause of chronic liver disease. It has also been associated with devastating outcomes such as decompensated liver cirrhosis and hepatocellular carcinoma, as well as diabetes and metabolic syndrome.Objectives: This study was conducted in order to assess liver fibrosis using Fibroscan, and to compare these results to the use of Fibrosis-4 (FIB-4) scores, AST platelet ratio index (APRI scores), and the AST/ALT ratios on NAFLD patients.Patients and Methods: A cross sectional study study was conducted on NAFLD patients who underwent Fibroscan examinations between September 1, 2011 and June 30, 2014. Demographic data was collected, including sex, age, and nationality; serum alanine aminotransferase levels (ALT, 30 - 65 U/L), serum aspartate aminotransferase levels (AST, 15 - 37 U/L), and platelet counts (150 - 400 k/mL) were also determined. The stages of fibrosis (F0 1 - 6, F1 6.1 - 7, F2 7 - 9, F3 9.1 - 10.3, and F4³ 10.4) were defined in kPa. For each patient, the AST/ALT ratio was also measured. The results of APRI and FIB-4 were compared with the Fibroscan fibrosis scores.Results: The results of 122 patients were analyzed, including 65 (53.3%) males with a mean age of 50.2 years (SD: 13.7; range: 18 - 86).The males were significantly younger than the females (48.7 years (SD: 16.03) versus 51.8 years (SD: 10.3 P=0.05), respectively). The mean stiffness score was 12.02 (SD: 12.7) kPa. Forty-four patients (36%) had advanced fibrosis. The mean platelet and serum ALT levels were normal. There was a significant positive correlation between the Fibroscan results and the AST/ALT ratios, the APRI scores, and the FIB-4 results. Similarly, there was a significant positive correlation between age and fibrosis score, and a significant negative correlation between platelet count and stiffness score.Conclusions: The data showed that more than one-third of the cohort exhibited advanced fibrosis, demonstrating the need for the early diagnosis and treatment of NAFLD. The use of Fibroscan with other serum markers has been shown to be helpful for the diagnosis of severe fibrosis.

Introduction: Non-alcoholic fatty liver disease (NAFLD) is considered to be a severe health threat across the world, the prevalence of which has significantly increased in recent years. Considering the role of diet in the pathogenesis of NAFLD, the present study aimed to evaluate and compare the dietary intakes of patients with NAFLD with healthy subjects. Methods: This case-control study was conducted on 120 participants aged more than 18 years. The case group included 60 patients who were diagnosed with NAFLD based on Fibroscan assessment. The diet records of the subjects were analyzed using a three-day dietary record questionnaire. Results: After modulation based on energy intake, the total intakes of energy, fiber, vitamin D, and vitamin E were significantly lower in the patients with NAFLD compared to the control group. In addition, the level of trans-fatty acids after energy adjustment was significantly higher in NAFLD patients compared to the controls. However, analysis after the energy adjustment indicated no significant difference between the case and control groups in terms of protein, carbohydrate, saturated fatty acid, monounsaturated fatty acid, and polyunsaturated fatty acid intakes. Conclusion: According to the results, the diet records of the patients with NAFLD and healthy subjects differed in terms of the intakes of energy, fiber, trans-fatty acids, vitamin D, and vitamin E. Therefore, special attention must be paid to the dietary patterns of these individuals in order to improve their lifestyle and prevent the occurrence and progression of NAFLD.