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Does Hepatosteatosis Affect Shear-Wave Elastography Values in Chronic Hepatitis Patients with the Same Histological

Emrah Karatay1, Abdulkadir Eren2

  • 1Department of Radiology, Sultan II. Abdulhamid Han Training and Research Hospital, Istanbul 34668, Türkiye.

Diagnostics (Basel, Switzerland)
|July 15, 2026
PubMed

Insights

Hepatosteatosis (fatty liver) does not significantly impact liver stiffness measurements in most fibrosis stages of chronic hepatitis. Shear-wave elastography remains reliable for monitoring patients with fatty liver disease.

Area of Science:

  • Hepatology
  • Medical Imaging
  • Gastroenterology

Background:

  • Percutaneous liver biopsy (PLB) traditionally assesses fibrosis in chronic hepatitis (CH) using Ishak and Knodell classifications.
  • Hepatosteatosis (HS) is frequently observed in PLBs and may influence fibrosis evaluation.
  • Shear-wave elastography (SWE) is an emerging non-invasive technique for assessing liver fibrosis.

Purpose of the Study:

  • To evaluate the impact of hepatosteatosis on liver fibrosis assessment in chronic hepatitis.
  • To compare shear-wave elastography (SWE) measurements with Ishak-Knodell fibrosis grades in the presence of varying degrees of steatosis.
  • To determine if steatosis affects SWE (kPa) results within specific fibrosis grades.

Main Methods:

  • Chronic hepatitis cases were stratified into three groups based on the presence and percentage of hepatosteatosis (<10% or ≥10%).
  • Ishak-Knodell fibrosis grades and SWE values (kPa) were analyzed for all patients.
  • Statistical comparisons were performed to assess the relationship between steatosis, fibrosis grades, and SWE values.

Main Results:

  • Of 236 CH patients, 109 (46.2%) had HS, with 78 (71.5%) showing ≥10% steatosis.
  • No significant difference in liver stiffness (kPa) was found between HS groups for Ishak-Knodell grades except F3 (p > 0.05).
  • A significant difference in kPa values was observed for the F3 fibrosis grade (p < 0.05).

Conclusions:

  • Liver stiffness (kPa) measurements by SWE correlate well with fibrosis grades in chronic hepatitis.
  • SWE is a viable tool for monitoring CH patients with hepatosteatosis, potentially reducing the need for invasive procedures.
  • Non-invasive SWE assessment enhances patient comfort and avoids unnecessary liver biopsies.

Keywords:
IshakKnodellchronic hepatitishepatosteatosisshear-wave elastography

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