Comparison of Liver Lobes Shear-Wave Elastography Values with Histopathological Classifications in Autoimmune Hepatitis Cases

Abstract

Background: The inflammatory liver illness known as autoimmune hepatitis (AIH) can develop into liver cirrhosis if therapy is delayed and the diagnosis is not made. Despite knowing that liver biopsy is the most reliable diagnostic technique, it cannot be tolerated by every patient and is relatively expensive. Shear-wave elastography (SWE) is increasingly used in the diagnosis of AIH. Objectives: In this study, the right and left liver lobe stiffness values of the patients were compared according to histopathological classifications. It was investigated whether the presence of AIH affected the Ishak and Knodell fibrosis stages and SWE measurements in the right and left lobes at a similar rate. Methods: Autoimmune hepatitis cases aged ≥ 18 years diagnosed between January 2023 and February 2025 were retrospectively screened. The cases with Knodell-Ishak classifications and SWE results were included in the research. SWE values were expressed in kilopascals (kPa) for both liver lobes. For the same fibrosis stage in Knodell and Ishak classifications, the average SWE values (right and left lobes) were compared. Results: There were 92 patients, 18 were males (19.6%) and 74 were females (80.4%). The youngest patient was 18 years old and the oldest was 71 years old; both were male. For all cases, median age (IQR) was calculated as 41.23 (11.36). The same Knodell and Ishak grades were used to compare the SWE values of the liver's left and right lobes. No statistical significance was found between the liver stiffness values in kPa for Knodell-Ishak classifications (P > 0.05). Conclusions: Shear-wave elastography is an easily applicable non-invasive method that provides quantitative values for the diagnosis of liver parenchyma. According to SWE values in this study, AIH affects both liver lobes similarly.