Clinical Evaluation of Hepatic Fibrosis in Chinese Patients with Nonalcoholic Fatty Liver Disease with FibroScan

Aim: The clinical value of FibroScan in evaluation of hepatic fibrosis was assessed in Chinese patients with nonalcoholic fatty liver disease (NAFLD). Methods: Liver stiffness and other NAFLD related variables were measured in NAFLD patients with either elevated or normal hyaluronic acid (HA) levels, and in healthy volunteers respectively. Moreover, hepatic fibrosis rat model was used for the correlation analysis between the measured liver elasticity and its corresponding pathological changes. Results: The severity of NAFLD in patients was positively correlated with both HA level and FibroScan values suggesting that fibrosis occured along with the progression of NAFLD. Interestingly, the FibroScan value was found to change at an earlier stage of the disease than that of HA level. The mean liver elasticity in the sampling volume of the region of interest in experimental rats, which were subject to the induction of liver fibrosis using peritoneal injection of carbon tetrachloride (CCl4) for 6 or 9 weeks respectively, was measured using Fibroscan. The examination of pathological changes of these experimental rats demonstrated the positive correlation of the measured elasticity values with the extent (severity) of the corresponding pathological changes in the rats of 6 weeks post induction of liver fibrosis with a moderate liver fibrosis, or 9 weeks with a severe liver fibrosis. The average liver stiffness for the normal liver (S0) was 4.51 ± 0.82 kPa, for moderate liver fibrosis (S2) was 6.91 ± 1.32 kPa, and for severe liver fibrosis (S3) 9.62 ± 1.82 kPa. Conclusion: FibroScan can be used to objectively and quantitatively identify the trend in the changing stiffness of the liver and noninvasively detect the development of liver fibrosis.