Dépistage non invasif de la fibrose : Intérêt du FibroScan® en consultation d'alcoologie [Noninvasive screening of fibrosis: interest of FibroScan® in alcohol addiction consultation]

2005 Alcoologie et Addictologie 27, 3 (191-196)

Non invasive detection of liver fibrosis. Value of FibroScan® in alcohol consulting out-patients FibroScan® is a new apparatus allowing noninvasive quantification of liver fibrosis by measuring the stiffness of the liver. This new method presents good diagnostic performances in patients with chronic hepatitis C. The objective of this study was to evaluate the acceptability of this examination, its value for the detection of cirrhosis and the distribution of liver fibrosis in alcohol consulting out-patients. 245 consecutive patients were included and needle liver biopsy was proposed when liver stiffness exceeded 13 kPa. All patients included accepted this new examination. The measurement could not be performed correctly in 18 patients because of excess weight. Of the 41 patients with liver stiffness greater than 13 kPa, three refused liver biopsy and three were primarily managed for other diseases. In the 35 patients in whom liver biopsy was performed, the presence of cirrhosis was confirmed in 34 cases and the last patient was precirrhotic. The positive predictive value was therefore 97 %. The platelet counts and prothrombin levels of 21 of these 34 cirrhotic patients were not suggestive of cirrhosis. Although the negative predictive value could not be evaluated in this study (proportion of patients with liver stiffness < 13 kPa without cirrhosis), this apparatus appears to be well adapted to the detection of cirrhosis in alcohol consulting out-patients.