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Fragmento Dear Editor, We have read with interest the comments of Dr. Ozalper concerning mainly some methodological aspects of our study. Dr. Ozalper cites the paper by Uslu, et al. that showed that the measurement of liver elasticity by adopting a subcostal site, rather than an intercostal site, provides a more accurate assessment of liver fibrosis severity. This observation could be of interest; nevertheless there are many differences between the study of Uslu, et al. and our study. First, to assess liver elasticity Uslu et al. employed real-time elastography (RTE) and not Acoustic Radiation Force Impulse elastography (ARFI). Thus, in the absence of head-to head studies, the results obtained using one technique cannot be translated to the other. Second, Uslu, et al. did not report the median number of portal tracts sampled, in order to establish the accuracy of RTE in predicting the severity of liver fibrosis. Finally, it is important to note that in our study only HCV positive liver transplanted patients have been enrolled while the population studied by Uslu, et al. enrolled 39 immune-competent patients of whom only 13 presented chronic HCV related hepatitis. The intercostal approach used in our study employing ARFI technique is still considered the best approach when the elastogram ROI is positioned trying to include the biopsy site, to get a better correlation between the two methods.

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2016-11-18   |   410 visitas   |   Evalua este artículo 0 valoraciones

Vol. 15 Núm.6. Noviembre-Diciembre 2016 Pags. 947-948 Ann Hepatol 2016; 15(6)