الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Cirrhosis is a complication of all chronic liver disease which
involves loss of liver cells and irreversible scarring of the liver. Alcohol
and viral hepatitis B and C are considered the commonest causes of
cirrhosis.
Approximately 10–20% of patients with chronic hepatitis C virus
infection have cirrhosis at first clinical presentation, and as many as 20–
30% of those who do not have cirrhosis will eventually develop this
condition and its complications within one or more decades.
Liver biopsy is currently considered the gold standard for assessing
hepatic fibrosis. However, it is an invasive and painful procedure with
rare but potential life threatening complications, limiting its acceptance
and repetition in usually asymptomatic patients. In addition, the accuracy
of liver biopsy in assessing fibrosis may be questioned because of
sampling error and inter observer variability, which may lead to miss
understating of cirrhosis.
Thereby came the need to develop and validate non-invasive tests
that can accurately reflect the full spectrum of hepatic fibrosis, cirrhosis
and its severity in liver diseases Transient elastography (FibroScan;
Echosens), is a novel, rapid, and non-invasive technique which measures
liver stiffness.
The aim of this work was to evaluate the accuracy of Transient
Elastography (Fibroscan) as a non-invasive method for Cirrhosis
assessment in chronic liver disease patients.
Our study included 50 chronic liver disease patients, referred
from Hepatology units in Menoufiya University for liver stiffness
measurement using fibroscan. The referred 50 patients were 32 males, 18
females with ages ranged from 34 to75 with mean age of 51years.
The size, surface and texture of patients liver were detected by ultra
sound examination, out of 50 cases, 14(28%) cases showed normal liver
size, 33(66%) were enlarged and 3(6%) were shrunked, Regarding the
liver surface, 84% of cases showed regular liver surface and 16% were
irregular liver surface. Twenty one cases were cirrhotic , 21 cases were
bright livers and 8 cases were coarse liver.
The mean reading of fibroscan in our study was 25.9 kpa with
success rate 98%, the maximum reading was 65.4 kpa with success
rate100% and the minimum was 9.5 kpa with success rate 69%.
Fibroscan revealed cirrhosis in all patients with F3grade detected in
15 patients (30%), F4 in 28 patients (56%)& 7 patients (14%) were grade
F3-F4.
Our study showed that high statistical significance between the
fibroscan and US finding as most patients with hepatomegaly and coarse
hepatic texture showed high fibroscan scores.
In our study fibroscan showed cut of level of 14.5 Kpa for
detection of cirrhosis with AUROC 1.00 with a sensitivity & specificity
100%. While Ultrasound showed sensitivity of 71% & specifity of 40%
for detection of cirrhosis.