Abstract: Objective The aim of this study was to investigate the noninvasive assessment of liver fibrosis (LF) via liver (LSM) and spleen stiffness measurement (SSM) using acoustic palpation elastography (APE) in patients with chronic hepatitis B (CHB). Methods A total of 392 patients with CHB were encountered in our hospital between January 2020 and October 2021, and all underwent liver biopsies. The LF was defined by METAVIR's score, and was divided into non-significant (less than F1) and significant (equal to or greater than F2). The LSM and SSM were obtained by using APE. The aspartate aminotransferase to platelet ratio index (APRI), FIB-4 and King's score were calculated. The diagnostic efficacy was evaluated by the the area under receiver operating characteristic curve (AUC). Results Out of the 392 patients with CHB, the histopathological examination showed F0 in 45 cases, F1 in 112 cases (non-significant LF in 157 cases), F2 in 105 cases, F3 in 70 cases and F4 (early cirrhosis) in 60 cases (significant LF in 235 cases); the LSM, SSM, APRI, FIB-4 and King's score in patients with significant LF were (13.4±2.0)kPa, (23.3±4.0)kPa,(2.2±0.4), (1.8±0.4) and (23.4±7.9), significantly greater than [(9.3±1.7)kPa, (15.0±3.6)kPa, (1.0±0.2), (0.9±0.2) and (10.4±6.9), respectively, P<0.05] in patients with non-significant LF; the multivariate Logistic regression analysis showed that the LSM, SSM, APRI, FIB-4 and King's score were all the independent factors impacting LF in patients with CHB (P<0.05); the sensitivity, specificity and accuracy of LSM and SSM combination in predicting significant LF were 79.6%, 83.0% and 81.6%, and in predicting early liver cirrhosis were 92.8%, 90.0% and 92.3%. Conclusion The application LSM and SSM by using APE in predicting the degree of liver fibrosis in patients with CHB is efficacious , which is worthy of further clinical investigation.

Key words: Hepatitis B, Liver fibrosis, Acoustic palpation elastography, Liver stiffness measurement, Spleen stiffness measurement, Diagnosis