Value of hepatic artery resistive index in evaluation of liver fibrosis related to non-alcoholic fatty liver diseases

Abstract

Background: Staging of liver fibrosis is essential for managing patients with nonalcoholic fatty liver disease (NAFLD). Liver biopsy has well-known limitations and cannot be proposed to all patients. Previous studies have demonstrated that hepatic artery resistive index (HARI) is significantly altered in NAFLD patients. The aim of this study is to assess the value of (HARI) in evaluating the progression of liver fibrosis in NAFLD patients. Patients and methods: This study was carried out on 100 NAFLD patients. All patients had undergone Doppler ultrasound and transient elastography (TE) with controlled attenuation parameter (CAP) to quantify the degree of steatosis. Laboratory work and calculation of FIB-4, ASTplatelets ratio index (APRI), NAFLD fibrosis score (NFS) were done. Sensitivity and specificity of HARI values for predication of liver fibrosis were estimated by the receiver operating characteristic curve. Results: The study revealed a statistically significant positive correlation of HARI with liver stiffness measurement (LSM) measured by fibroscan, FIB4, NFS, age, Hba1c, fasting blood sugar (P <0.0001 for all) and LDL, HDL and albumin. However, a significant negative correlation of HARI with CAP was detected (P= 0.03). At a cutoff value of 0.76, HARI had 80% sensitivity and 76% specificity for prediction of advanced fibrosis (> 9.1 KPa) with area under ROC curve equal to 0.826. Moreover, HARI at a cutoff value 0.74 showed 83% sensitivity and 72% specificity for the prediction of liver cirrhosis (≥ 10.4 KPa) with the area under the ROC curve equal to 0.803. Conclusion: HARI is a good non-invasive tool to predict the risk of liver fibrosis progression in patients with NAFLD particularly advanced fibrosis and cirrhosis. HADRI correlates with other non-invasive methods of assessment of fibrosis including LSM, CAP, FIB4 and NFS, and may provide an easy, available tool for monitoring of patients with NAFLD. Patients and methodsThis study was carried out on 100 patients (28 males and 72 females) with NAFLD aged between (30-66) years old recruited from an out and inpatient clinic of Tropical medicine department, Mansoura University, Dakahlya, Egypt, between June 2018 and May 2021. All patients aged 18 years old and above with body mass index (BMI) more than 25 and evidence of any grade of fatty liver by ultrasonography. All subjects have signed a written