To explore the value of sound touch elastography (STE) in detecting spleen stiffness for the assessment of liver fibrosis in patients with chronic hepatitis B.

Seventy-three patients with chronic hepatitis B were retrospectively recruited between January 2019 and March 2020 at our hospital. All the patients underwent serological examinations of platelets, aspartate aminotransferase, and alanine aminotransferase to calculate the FIB-4 index, as well as STE examination and pathological examination after liver puncture. The correlation between spleen stiffness and liver fibrosis was judged by taking pathological results as the gold standard. Based on the pathological results, the patients were divided into non-fibrosis group (S0), mild fibrosis group (S1+S2), and moderate and severe fibrosis group (S3+S4), and the t-test was used to compare the differences in splenic STE value and FIB-4 value between these groups. Receiver operating characteristics curve analysis was performed to assess the diagnostic efficacy of splenic STE value and FIB-4 value in the diagnosis of different degrees of liver fibrosis. The Z test was used to compare the FIB-4 index and splenic STE value in the diagnosis of liver fibrosis and moderate to severe liver fibrosis.

With the increase of the severity of liver fibrosis, the mean value of spleen elastic modulus [(10.84±2.42) kPa vs (16.95±4.95) kPa vs (23.25±6.81) kPa] and FIB-4 value [(1.02±0.65) vs (1.74±0.74) vs (2.97±1.34)] in the non-fibrosis group (n=8), the mild fibrosis group (n=41), and the moderate and severe fibrosis group (n=24) increased gradually; the differences between groups were statistically significant (P＜0.05). The best critical value of splenic STE value in the diagnosis of hepatic fibrosis was 12.3 kPa, and the corresponding sensitivity and specificity were 88.5% and 75.0%, respectively. The best critical value of splenic STE value in the diagnosis of moderate and severe hepatic fibrosis was 21.9 kPa, and the corresponding sensitivity and specificity were 87.5% and 83.7%. Splenic STE value was positively correlated with FIB-4. Splenic STE value and FIB-4 index were both significant for the diagnosis of liver fibrosis and moderate to severe liver fibrosis, but the area under the curve of splenic STE value was significantly higher than that of the FIB-4 index (0.871 vs 0.741, Z=6.12, P=0.001; 0.798 vs 0.735, Z=6.35, P=0.001).

STE as a noninvasive examination method for the detection of spleen stiffness, has appreciated diagnostic value for liver fibrosis in patients with chronic hepatitis B.