Abstract: Objective This study was conducted to investigate the assessment of significant liver fibrosis (SLF) by visual instantaneous elastography (VIE) and acoustic palpation elastography (APE) in patients with chronic hepatitis B (CHB). Methods 121 patients with CHB were encountered in our hospital between October 2020 and October 2022, and all patients underwent liver biopsies for liver fibrosis staging and ultrasonography for liver stiffness measurement (LSM). The area under the receiver operating characteristic curve (AUROC) was drawn to reveal the diagnostic performance of LSM for predicting the SLF. Results Out of the 121 patients with CHB, the liver histo-pathological examination showed SLF in 95 cases, and non-significant liver fibrosis (NSLF) in 26 cases; the LSMvie and LSMape, serum aspartate aminotransferase and alanine aminotransferase levels in patients with SLF were (9.3±3.0)kPa,(9.3±3.1)kPa, (127.5±33.4)U/L and (137.8±38.8)U/L, all significantly higher than [(5.9±1.4)kPa, (6.0±1.5)kPa, (98.6±25.8)U/L and (90.5±28.7)U/L, respectively,P<0.05], while the blood platelet count was (125.8±41.5)×10⁹/L, much lower than [(192.3±51.7)×10⁹/L, P<0.05] in patients with NSLF; the sensitivity, specificity, accuracy, positive predictive value and negative predictive value by VIE in predicting SLF in patients with CHB were 95.8%, 88.5%, 94.2%, 96.8% and 85.2%, not significantly different as compared to 94.7%, 84.6%, 92.6%, 95.7% and 81.5% by APE (P>0.05). Conclusion The diagnostic accuracies of VIE and APE in predicting SLF in patients with CHB are both great, which might be useful in clinical practice, and warrants further investigation.

Key words: Hepatitis B, Liver fibrosis, Visual instantaneous elastography, Acoustic palpation elastography, Diagnosis