The diagnostic accuracy of liver fibrosis in non-viral liver diseases using acoustic radiation force impulse elastography: A systematic review and meta-analysis

Autoři: Yuanqiang Lin aff001;  Hequn Li aff001;  Chunxiang Jin aff001;  Hui Wang aff001;  Bo Jiang aff002
Působiště autorů: Department of Ultrasound, China-Japan Union Hospital, Jilin University, China aff001;  Department of General Surgery, Nanhu Hospital, China-Japan Union Hospital, Jilin University, China aff002
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article



Acoustic radiation force impulse (ARFI) imaging is an ultrasound-based elastography method that has been studied in the staging of hepatic fibrosis, especially in chronic hepatitis. However, the diagnostic accuracy of ARFI in non-viral hepatopathies, such as autoimmune hepatitis and non-alcoholic fatty liver disease, has not been systematically determined.


To systematically assess the diagnostic accuracy of ARFI in non-viral hepatopathies.


The databases of PubMed, Embase, Cochrane Library and were systematically searched for candidate studies reporting the diagnostic accuracy of ARFI for hepatic fibrosis. The pooled estimates of the sensitivity, specificity, diagnostic odds ratio, and positive and negative likelihood ratios were calculated with the summary receiver operating curve (sROC) performed using STATA software.


In detail, a total of 29 diagnostic studies were included for further analysis. The quality of the included studies was relatively high using QUADAS method. The pooled sensitivity and specificity were 0.79 (0.73, 0.83) and 0.81 (0.75, 0.86), with AUROC 0.87 (0.83, 0.89) for the staging of significant fibrosis (F≥2). Meanwhile, for the staging of severe fibrosis (F≥3), the pooled sensitivity and specificity were 0.92 (0.87, 0.95) and 0.85 (0.80, 0.89), with AUROC 0.94 (0.92, 0.96). Furthermore, the pooled sensitivity and specificity were 0.89 (0.79, 0.95) and 0.89 (0.85, 0.92), with AUROC 0.94 (0.92, 0.96) for ARFI in staging cirrhosis (F = 4), which were similar to the data for severe fibrosis. No significant publication bias was present in this study.


This meta-analysis demonstrated that ARFI exerted satisfactory diagnostic performance in staging non-viral hepatic fibrosis, especially severe fibrosis (F≥3) and cirrhosis (F = 4).

Klíčová slova:

Cirrhosis – Database searching – Diagnostic medicine – Fibrosis – Liver diseases – Liver fibrosis – Liver transplantation – Metaanalysis


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