The influence of liver residual mass on the values of Acoustic Radiation Force Impulse Elastography (ARFI) in cirrhotic patients

Aim: The aim of our study was to assess the influence of liver residual mass in cirrhotic patients on the liver stiffness (LS), measured by ARFI elastography. Methods: Two hundreds eleven cirrhotic patients were enrolled. To evaluate the liver residual mass, the Child-Pugh and MELD scores were used and 10 valid ARFI measurements were performed. The correlation between Child-Pugh, MELD scores and the LS were evaluated. Results: Valid ARFI measurements were not obtained in 3 patients. A direct, very low correlation between the LS values and the Child-Pugh (r= 0.264, p< 0.001) and MELD scores (r= 0.194, p= 0.005) was found. A direct, low correlation between LS measurements and total bilirubin (r= 0.271, p< 0.001) and an inverse, low correlation with albumin (r=-0.270, p< 0.001), prothrombin time (r=-0.196, p= 0.006), cholinesterase (r=0.241, p= 0.003) was obtained. The LS mean values were statistically significant higher in patients with Child-Pugh class B vs. A (p= 0.002) and in Child-Pugh C vs. A (p< 0.001). The values were not significantly different in patients with Child-Pugh B vs. C (p= 0.06). Conclusions: Higher values of LS measurements by means of ARFI could be an indicator of decreased liver functional reserve, evaluated by means of Child Pugh or Meld scores.