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Lunes 10 de agosto 2020   BUSQUEDA
Shiha  Gamal E, El-Etreby  Shahira, Bahgat  Mounir, Hamed  Magdy, El Sherbini  Mohamed, Ghoneem  Elsayed A, Zalata  Khaled, et al  .
Chronic Hepatitis C Patients with Obesity:
Do We Need Two Operators for Accurate Evaluation of Liver Stiffness?
Ann Hepatol 2018; 17(5)  : 95-801


Introduction and aim. Transient elastography is gaining popularity as a non-invasive method for predicting liver fibrosis, but inter observer agreement and factors influencing reproducibility have not been adequately assessed.

Material and methods. This cross-sectional study was conducted at Specialized Medical Hospital and the Egyptian Liver Foundation, Mansoura, Egypt. The inclusion criteria were: age older than 18 years and chronic infection by hepatitis C. The exclusion criteria were the presence of ascites, pacemaker or pregnancy. Three hundred and fifty-six patients participated in the study. Therefore, 356 pairs of exams were done by two operators on the same day.

Results. The overall inter observer agreement ICC was 0.921. The correlation the two operators was excellent (Spearman’s value q = 0.808, p < 0.001). Inter-observer reliability values were ê = 0.557 (p < 0.001). A not negligible discordance of fibrosis staging between operators was observed (87 cases, 24.4%). Discordance of at least one stage and for two or more stages of fibrosis occurred in 60 (16.9%) and 27 cases (7.6%) respectively. Obesity (BMI > 30 kg/m2) is the main factor associated with discordance (p = 0.002).

Conclusion. Although liver stiffness measurement has had an excellent correlation between the two operators, TE presented an inter-observer variability that may not be negligible.

Palabras clave: Transient elastography, fibroScan, inter observer variability, chronic hepatitis C, BMI.
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