Objectives: To examine the relationships between fibrosis amounts evaluated by morphometric analysis and liver stiffness measurement (LSM) as well as the influence of steatosis, of activity grade and of the type of chronic liver injury.
Methods: One hundred and fifty-two consecutive patients were selected from a prospective cohort of patients with concurrent liver biopsy and LSM on the basis of a more than 25 mm long liver biopsy. Morphometric quantification of collagen deposition was expressed as fibrosis area fraction (FAF). Steatosis, activity grade, and predominant type of liver injury (chronic hepatitis or steatohepatitis) were assessed.
Results: In the whole population (chronic viral hepatitis n = 96, alcoholic or nonalcoholic steatohepatitis n = 56), FAF was significantly correlated to LSM (rho = 0.6, P<0.0001). Steatosis independently influenced LSM in patients without cirrhosis, but not activity grade. In the absence of cirrhosis, LSM and FAF were correlated in patients with chronic hepatitis (rho = 0.49, P<0.0001) but not in those with steatohepatitis (rho = 0.22, P = 0.16). In cirrhotic patients, LSM was correlated with fibrosis amount. (rho = 0.43, P = 0.006). The area under the receiver operating characteristics curve of LSM was 0.75 for separating no or minor fibrosis from significant fibrosis and 0.9 for the diagnosis of cirrhosis.
Conclusion: LSM was significantly correlated with collagen deposition. However, the relationships between LSM and fibrosis amount seems to differ according to steatosis and to the pattern of liver fibrosis below the cirrhotic stage. Its performances are fair for segregating patients with no or minor fibrosis from those with significant fibrosis and high for the diagnosis of cirrhosis.