الفهرس 
LIVER FIBROSISOnly 14 pages are availabe for public view
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Abstract
The prognosis and management of chronic liver diseases greatly depends on the degree and progression of liver fibrosis. Until recently, liver biopsy was the only way to evaluate fibrosis in the liver. However, liver biopsy is an invasive and painful procedure, with rare but potentially life-threatening complications. Thus, many patients are reluctant to undergo liver biopsies, The accuracy of liver biopsy in assessing fibrosis has also been questioned in relation to sampling errors and intra- and interobserver variability that may lead to over- or understaging .Ideally, a noninvasive marker of liver fibrosis should be liver-specific, easy to perform, reliable, and inexpensive. In addition, it should be accurate not only for the grading of fibrosis, but also for the monitoring of disease progression and the efficacy of antiviral therapy.
Liver stiffness was determined by transient elastography (Fibroscan), In brief an ultrasound transducer probe is mounted on the axis of a vibrator; vibrations of mild amplitude and low frequency induce an elastic shear wave that propagates through underlying liver tissue. Pulse-echo ultrasound acquisitions are used to follow propagation of the shear wave and measure its velocity. The harder the tissue the faster the wave. Results are expressed in kilopascals.
In our study we evaluated the effectiveness of fibroscan in comparison to liver biopsy ,and we found that fibroscan can diagnose no or mild fibrosis stages F0 & F1 with sensitivity, Specificity, PPV, NPV, equal 96.3%, 66.7%, 96.3, 66.7% and 93.3% diagnostic accuracy respectively.
For diagnosis of cirrhosis, sensitivity, Specificity,PPV ,NPV equal 83.3%,91.7%,71,4%,95,7% and 90% diagnostic accuracy respetively.
For identification of the target group of patients who
will be included in programs of interferon therapy ;
(stages F2 & F3) sensitivity, Specificity,PPV ,NPV,equal 85.7%,77.8%,. 90%,70%,and 83.3% diagnostic accuracy respectively.
For differentiation between mild and moderate fibrosis (F0, F1, F2) from severe fibrosis and cirrhosis (F3 & F4). We found that fibroscan differentiate mild, moderate fibrosis from severe fibrosis and cirrhosis perfectly with sensitivity, Specificity,PPV ,NPV and diagnostic accuracy equal 100%.