Shear wave velocity is a useful marker for managing nonalcoholic steatohepatitis

Figure 1 Reliability and variation of shear wave velocity (SWV) throughout the liver. SWV was measured independently three times at each of the right (Rt) or left (Lt) lobes in four patients with fibrosis stage 3, labeled cases 10 to 13. Each horizontal bar indicates an average SWV.

Figure 2 Average shear wave velocity (SWV) and representative photomicrographs in each fibrosis stage. SWV was measured in four segments; right anterior, right posterior, left medial and left lateral segments, and the average was calculated based on data from four segments (A) or from either one of right [Rt, (C)] or left [Lt, (D)] lobes. Histological fibrosis stages were judged along with Brunt criterion. Each horizontal bar indicates an average SWV. ^aP < 0.05. The photomicrographs (B) are representative Masson’s trichrome stains for fibrosis stages 1, 2, 3 and 4 from upper left, lower left, and upper right to lower right panels, respectively. Original magnification is × 100.

Figure 3 Receiver-operator characteristic curve (ROC) of SWV or platelet count to distinguish fibrosis stages 3 and 4 from stage 0-1. ROC to discriminate fibrosis stages 3 and 4 from stage 0-1 by SWV (A) or platelet count (B) revealed sensitivity, specificity and area under ROC of 100%, 75% and 94.2%, or 100%, 57.1% and 61%, respectively, when 1.47 m/s or 17.8 × 10 000/mm³ was selected as a cutoff value. A small graph incorporated in each ROC graph shows the distribution of SWV or platelet count in fibrosis stages 0-1 and 3-4. The dotted line indicates the cut-off value selected.

Figure 4 Correlation between SWV and serum biochemical parameters. SWV was plotted against hyaluronic acid (A) and serum concentration of albumin (B). A gray scale indicates the fibrosis stages, with white representing 0-1 through to dark gray for stage 4.