Abstract
BACKGROUND AND AIMS: Effective hepatic blood flow (EHBF) decreases with liver disease progression, and identifying liver pathology is critical for patients with liver disease. This study was designed to elucidate the correlation between EHBF and liver pathology and explore the potential of EHBF for predicting the degree of liver pathology. METHODS: In this study, 207 patients with hepatitis B virus (HBV) who underwent liver biopsy and indocyanine green (ICG) clearance tests were enrolled. EHBF was measured using the ICG clearance test, and liver tissue was histologically analyzed to determine the pathological stage according to the Scheuer scoring system. Demographic data, biochemical indexes, and FibroScan data were collected for statistical analysis. RESULTS: EHBF levels decreased as the liver histological stages of inflammation and fibrosis increased (P < 0.01). EHBF was significantly negatively associated with the levels of alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, alkaline phosphatase, aspartate aminotransferase-to-platelet ratio index, fibrosis index based on the four factors, and liver stiffness measurement (P < 0.05). The EHBF levels of patients without liver inflammation (G0) were significantly higher than those of patients with liver inflammation (G1-4) (P < 0.001). The area under the receiver operating characteristic curve (AUROC) value for discriminating patients without liver inflammation was 0.827, and the optimal cutoff value was 0.936 L/min. The EHBF levels of patients with severe liver inflammation (G4) were significantly lower than those of patients with G0-3 liver inflammation (P < 0.001). The AUROC value for discriminating patients with severe liver inflammation was 0.792, and the optimal cutoff value was 0.552 L/min. The EHBF levels of patients without liver fibrosis (S0) were significantly higher than those of patients with liver fibrosis (S1-4) (P < 0.001). The AUROC value for discriminating patients without liver fibrosis was 0.633, and the optimal cutoff value was 1.173 L/min. The EHBF levels of patients with liver cirrhosis (S4) were significantly lower than those of patients with S0-3 liver fibrosis (P < 0.001). The AUROC value for discriminating patients with liver cirrhosis (S4) was 0.630, and the optimal cutoff value was 0.562 L/min. CONCLUSIONS: EHBF levels and liver pathology are significantly correlated. EHBF could effectively reflect liver inflammation and fibrosis in patients infected with HBV, especially for patients without liver inflammation or liver fibrosis.