Comparative Evaluation of the Degree of Liver Fibrosis on Ultrasound-Based Fibroscan and Hyaluran Tests in Patients with Chronic Liver Disease.

Background: Chronic liver disease (CLD) in the clinical context is a disease process affecting the liver, which involves a process of progressive destruction and regeneration of the liver parenchyma, leading to fibrosis and cirrhosis. Both FibroScan, which is an ultrasound study also known as transient elastography, and Hyaluran test (biochemical test) are rapid safe non-invasive examinations of the liver, which can be used to monitor the degree and progression of fibrotic changes in the liver.

Objective: The purpose of this study was to compare the degree of liver fibrosis, as measured on ultrasound-based FibroScan and Hyaluran tests in CLD.

Materials and methods: This was a two-stage comparative study carried out on patients with clinically diagnosed CLD and non-CLD subjects at Jos University Teaching Hospital (JUTH) from January to June 2022. The first stage involved the use of ultrasound-based FibroScan to assess the degree of tissue stiffness in the liver of both CLD and non-CLD subjects. The unit of measurement of FibroScan is kilopascals (Kpa). In the second stage, blood samples were collected from CLD and non-CLD subjects for Hyaluran tests. The unit of measurement of Hyaluran tests is expressed in nanograms per milliliter (ng/mL).

Results: This study comprises of 75 apparently normal subjects and 75 CLD patients. The mean FibroScan level was significantly higher (17.55 ± 7.5 kPa) in patients with CLD compared to apparently normal subjects (5.06 ± 3.1 kPa), t = 5.783; P < 0.001. The mean Hyaluran value in the patients with CLD was 30.01 ± 20.39 ng/mL, which was significantly higher than that in the normal subjects with the mean value of 20.39 ± 8.27 ng/mL, t = 3.784; P < 0.001. In evaluating the correlation between FibroScan and Hyaluran in assessing the degree of fibrosis using the Spearman correlation coefficient, it was observed that the degree of fibrosis at the earlier stage (minimal) signifies a positive but weak correlation (P = 0.151), but this was not statistically significant (P = 0.492). However, mild/moderate and severe fibrosis demonstrate moderate positive (P = 0.505 and 0.550) and statistically significant correlation with P value of 0.020 and 0.011, respectively.

Conclusion: The study demonstrated a statistically significant difference in the mean FibroScan value in non-CLD and CLD cases. The results also indicated statistically significant difference in the mean Hyaluran value in non-CLD and the CLD cases. The study demonstrated a significant correlation between Hyaluran and FibroScan in assessing the degree of moderate and severe fibrosis in CLD.