Abstract: Objective The aim of this study was to explore the evaluation of significant liver fibrosis by hepatic vein waveform classification and ultrasound-based semi-quantitative scoring in patients with chronic hepatitis B(CHB). Methods 126 patients with CHB were admitted to our hospital between February 2018 and December 2020, and all patients with CHB underwent liver biopsies and were examined by ultrasound. The ultrasound semi-quantitative score of liver and the hepatic vein waveform typing were recorded. The diagnostic efficacy of sonographic parameters in predicting significant liver fibrosis (>=S2) was evaluated by the area under the receiver operating characteristic curve (AUC) by MedCal 15.2 software. Results The histopathological examination showed S0 in 20, S1 in 28, S2 in 31, S3 in 22 and S4 in 25 cases; the ultrasound semi-quantitative scores in patients with S0, S1, S2, S3, and S4 were(3.1±0.5), (5.4±0.9), (6.7±1.1), (8.3±1.5) and (9.9±1.8), significantly different among them(P<0.05); the percentages of HV type I and HV type II in patients with S3 and S4 were 40.9% and 56.0%, both significantly higher than 5.0%, 10.7%, 16.1% (P<0.05) in patients with S0, S1 and S2; the AUCs of hepatic venous waveform, ultrasound semi-quantitative scoring and the combination of the two in predicting significant liver fibrosis were 0.846(95%CI:0.753-0.938), 0.827(95%CI:0.729-0.924) and 0.919(95%CI:0.853-0.985), suggesting the combination of the two parameters was superior to any one of the parameter alone(P＜0.05), and its sensitivity and specificity were 85.1% and 97.5%, significantly higher than 87.2% and 83.5% by hepatic venous waveform or 85.1% and 86.1% by ultrasound semi-quantitative scoring. Conclusion The combination of hepatic vein waveform classification and ultrasonographic semi-quantitative scoring is efficacious in assessing the liver fibrosis staging in patients with CHB, which might provide an alternative imaging tool in clinical practice.

Key words: Hepatitis B, Liver fibrosis, Hepatic vein waveform classification, Ultrasound semi-quantitative score, Diagnostic trial