Viscosity Plane-Wave Ultrasound Combined With Serum Biomarkers for Detection of Significant Liver Inflammation: A...

Accurate prediction of significant liver inflammation is critical for making clinical intervention decisions. This study aims to establish a predictive model for detection of significant liver inflammation and assess its diagnostic performance against established scoring systems.

This study enrolled patients who underwent ultrasound-guided liver biopsy between July 26, 2024, and November 30, 2024. Demographic data, laboratory parameters, viscosity plane-wave ultrasound (Vi PLUS), mean values and histopathological inflammation grading, fibrosis stage were collected. A nomogram model was generated based on a multivariate logistic regression analysis to identify potential predictors associated with liver inflammation. The diagnostic performance was evaluated by receiver operating characteristic curve analysis, calibration plot and decision curve.

A total of 140 participants were included in this study. 98 patients were classified into the significant inflammation group (≥G2), and 42 patients were categorized as mild inflammation (G0-G1). Based on univariate and multivariate logistic regression analyses, Vi PLUS mean (odds ratios [OR]: 9.060) and aspartate aminotransferase (AST) (OR: 2111.269) were identified as independent risk factors for inflammatory grade (p < 0.05). The area under the curve (AUC) of the nomogram constructed by Vi PLUS mean and AST was 0.941 (95% confidence intervals 0.898-0.983, sensitivity 92.9%, specificity 85.7%), outperforming AST to platelet ratio index (AUC = 0.897), Vi PLUS mean (AUC = 0.897), FIB-4 (AUC = 0.885), AST (AUC = 0.852) and gamma-glutamyl transpeptidase to platelet ratio (AUC = 0.755) (all p < 0.05). Furthermore, a well-fitted calibration curve and a good clinical application value were achieved in the nomogram. The cutoff value of 0.538 was determined to predict significant inflammation.

The nomogram exhibits high accuracy in predicting significant liver inflammation and provide a new approach for clinicians to better evaluate inflammatory activity.