Diagnostic value of two dimensional shear wave elastography combined with texture analysis in early liver fibrosis

BACKGROUND

Staging diagnosis of liver fibrosis is a prerequisite for timely diagnosis and therapy in patients with chronic hepatitis B. In recent years, ultrasound elastography has become an important method for clinical noninvasive assessment of liver fibrosis stage, but its diagnostic value for early liver fibrosis still needs to be further improved. In this study, the texture analysis was carried out on the basis of two dimensional shear wave elastography (2D-SWE), and the feasibility of 2D-SWE plus texture analysis in the diagnosis of early liver fibrosis was discussed.

AIM

To assess the diagnostic value of 2D-SWE combined with textural analysis in liver fibrosis staging.

METHODS

This study recruited 46 patients with chronic hepatitis B. Patients underwent 2D-SWE and texture analysis; Young's modulus values and textural patterns were obtained, respectively. Textural pattern was analyzed with regard to contrast, correlation, angular second moment (ASM), and homogeneity. Pathological results of biopsy specimens were the gold standard; comparison and assessment of the diagnosis efficiency were conducted for 2D-SWE, texture analysis and their combination.

RESULTS

2D-SWE displayed diagnosis efficiency in early fibrosis, significant fibrosis, severe fibrosis, and early cirrhosis (AUC > 0.7, P < 0.05) with respective AUC values of 0.823 (0.678-0.921), 0.808 (0.662-0.911), 0.920 (0.798-0.980), and 0.855 (0.716-0.943). Contrast and homogeneity displayed independent diagnosis efficiency in liver fibrosis stage (AUC > 0.7, P < 0.05), whereas correlation and ASM showed limited values. AUC of contrast and homogeneity were respectively 0.906 (0.779-0.973), 0.835 (0.693-0.930), 0.807 (0.660-0.910) and 0.925 (0.805-0.983), 0.789 (0.639-0.897), 0.736 (0.582-0.858), 0.705 (0.549-0.883) and 0.798 (0.650-0.904) in four liver fibrosis stages, which exhibited equivalence to 2D-SWE in diagnostic efficiency (P > 0.05). Combined diagnosis (PRE) displayed diagnostic efficiency (AUC > 0.7, P < 0.01) for all fibrosis stages with respective AUC of 0.952 (0.841-0.994), 0.896 (0.766-0.967), 0.978 (0.881-0.999), 0.947 (0.835-0.992). The combined diagnosis showed higher diagnosis efficiency over 2D-SWE in early liver fibrosis (P < 0.05), whereas no significant differences were observed in other comparisons (P > 0.05).

CONCLUSION

Texture analysis was capable of diagnosing liver fibrosis stage, combined diagnosis had obvious advantages in early liver fibrosis, liver fibrosis stage might be related to the hepatic tissue hardness distribution.

Butanol production from the effluent of hydrogen fermentation

The purpose of the study was to recover butanol from the effluent of the hydrogen-producing bioreactor containing acetate, butyrate, and carbohydrate. The butanol production by Clostridium beijerinckii NRRL B592 was evaluated under both unsterilized and sterilized conditions for examining the potential of butanol production for the practical application. Sucrose of 10 g/L and butyrate of 2 g/L coupled with acetate buffer were used to mimic the effluent. Sucrose was completely consumed in the both unsterilized and sterilized conditions during acetone-butanol-ethanol (ABE) fermentation. However, the results illustrate that the carbohydrate consumption rate in the unsterilized condition was higher than that in the sterilized condition. The maximum butanol concentrations of 3,500 and 3,750 mg/L were achieved in the sterilized and unsterilized conditions, respectively. Meanwhile, it was found that the acetate and the butyrate concentrations of 600 and 1,500 mg/L, and 300 and 1,000 mg/L were ingested to yield butanol in the sterilized condition and in the unsterilized condition, respectively. The results concluded that high levels of acetate and butyrate could eliminate the interference of other microbial populations, resulting in the enrichment of C. beijerinckii NRRL B592 in the fermentor. The butanol production by C. beijerinckii NRRL B592 could be, therefore, produced from the effluent of the hydrogen-producing bioreactor. It promised that the microbial butanol production is one of attractive bioprocesses to recover energy from wastes.