COMPARATIVE ACCURACY OF 2-D SHARE WAVE ELASTOGRAPHY WITH CHILD PUGH SCORING IN LIVER FIBROSIS

Abstract

Background: Liver fibrosis is a progressive response to chronic liver injury, resulting in scar tissue formation and potential evolution into cirrhosis. Early and accurate staging is critical for timely intervention. Two-dimensional shear wave elastography (2D-SWE) provides non-invasive quantification of liver stiffness, while the Child-Pugh score assesses liver function based on bilirubin, albumin, prothrombin time, ascites, and encephalopathy. Comparing these tools enhances clinical decision-making in chronic liver disease management.

Objective: To assess the comparative accuracy of 2D shear wave elastography and the Child-Pugh scoring system in evaluating the severity of liver fibrosis.

Methods: This analytical cross-sectional study was conducted at INMOL Hospital and Aznostics Diagnostic Centre, Lahore. A total of 169 patients with chronic liver disease were selected through convenience sampling. Adults with hepatitis B, hepatitis C, non-alcoholic fatty liver disease, or hepatic steatosis were included, while those with decompensated cirrhosis, prior liver transplantation, or comorbid fluid overload were excluded. Liver stiffness was measured using 2D-SWE, and liver function was classified using the Child-Pugh scoring system. Spearman’s correlation test was used to determine the strength and significance of the association between fibrosis staging and liver function status.

Results: Among 169 participants, 43.2% were aged 25–40 years, 38.5% were 41–55 years, and 18.3% were above 55 years. Hepatitis B and C were found in 68.6% and 31.4% of cases, respectively. Frequent weight loss (63.3%), fatigue (65.1%), yellowish appearance (68.6%), and body swelling (31.4%) were reported. Liver size was <12 cm in 11.2%. Fibrosis grades were F0 (24.9%), F1 (20.1%), F2 (30.8%), F3 (15.4%), and F4 (8.9%). Child-Pugh scores were A (75.7%), B (13.0%), and C (11.2%). A strong correlation was observed between fibrosis stage and Child-Pugh score (Spearman’s ρ = 0.759; p < 0.0001).

Conclusion: 2D-SWE demonstrated high diagnostic relevance in assessing liver fibrosis, correlating strongly with Child-Pugh classification. These findings support the utility of SWE as a non-invasive alternative for evaluating liver disease severity and guiding clinical management.