Abstract: Objective This study aimed to investigate diagnostic performance of acoustic radiation force impulse (ARFI)-based tissue quantification in assessing significant liver fibrosis (SLF) in patients with chronic hepatitis B (CHB). Methods A total of 97 patients with CHB were admitted to our hospital between June 2023 and June 2025, and all underwent liver biopsy. Shear wave velocity (SWV) was obtained by ARFI, aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on four factors (FIB-4) were calculated. Serum hyaluronic acid (HA) level was routinely detected. Receiver operating characteristic (ROC) curve analysis was applied to evaluate the diagnostic performance. Results Age, serum ALT and AST levels in 50 patients with SLF were significantly older or higher, while peripheral blood platelet count was significantly lower than in 47 patients with non-SLF(P<0.05); SWV, APRI and FIB-4 scores, and serum HA level in patients with SLF were (2.1±0.4)m/s, (1.2±0.7), (2.0±1.0) and 132.2(95.4,210.5)ng/ml, all much higher than [(1.3±0.3)m/s, (0.6±0.3), (1.0±0.4) and 55.2(38.4,72.6)ng/ml, respectively, P<0.05] in those with non-SLF; the AUC was 0.94(95%CI:0.90-0.97), with sensitivity of 91.5% and specificity of 86.0%, when SWV was combined with any other fibrosis index mentioned above in predicting SLF in patients with CHB. Conclusion Combination of SWV with other liver fibrosis index commonly used could help clinicians screen liver fibrosis in patients with CHB, which warrants further investigation.

Key words: Hepatitis B, Acoustic radiation force impulse-based tissue quantification, Shear wave velocity, Aspartate aminotransferase-to-platelet ratio index, Fibrosis index based on four factors, Hyaluronic acids, Diagnosis