Abstract: Objective To investigate the diagnostic value of virtual touch tissue quantitfication (VTQ) and contrast-enhanced ultrasound (CEUS) in evaluating the chronic hepatitis B liver fibrosis. Methods Sixty-five patients with chronic hepatitis B were assessed by VTQ, CEUS and liver biopsy respectively to obtain the shear wave velocity (SWV) and contrast parameters of the liver，including portal vein arrival time (PVAT), hepatic artery time of arrival (HAAT), hepatic vein arrival time (HVAT), time to peak liver parenchyma (TTP), hepatic artery-hepatic vein transit time (HV-HAAT) and hepatic artery-portal vein transit time (PV-HAAT). According to the pathological results, sixty-five chronic hepatitis B patients were divided into mild group (n=12), moderate group (n=23) and severe group (n=30). The differences of SWV and CEUS parameters were compared between different groups. The correlation between SWV and CEUS parameters and the degree of liver fibrosis was analyzed. The receiver operating characteristic (ROC) curve was drawn to find the cut-off values of SWV and CEUS parameters for the diagnosis of severe liver fibrosis. The area under the curve (AUC) was calculated to evaluate the diagnostic efficacy of SWV and CEUS parameters for severe liver fibrosis. Delong method was used to compare the differences of different AUC detection methods. Results Compared with the mild group, SWV increased in the moderate group and severe group, and HVAT and HV-HAAT decreased in the severe group (P＜0.05). Compared with the moderate group, SWV increased and HVAT and HV-HAAT decreased in the severe group (P＜0.05). There was a positive correlation between SWV and the severity of liver fibrosis (rs=0.713, P＜0.05). There was a negative correlation between HVAT, HV-HAAT and the severity of liver fibrosis (rs = -0.437 and -0.620, respectively, P＜0.05). In the severe group, the areas under the curve for the diagnosis of liver fibrosis (cirrhosis) by SWV, HVAT and HV-HAAT were 0.925 (0.832-0.976), 0.734 (0.610-0.836) and 0.804 (0.687-0.892), and the cut off values were 1.92 m/s, 21.02 s and 8.23 s, respectively. The diagnostic efficiency of SWV in severe liver fibrosis (cirrhosis) was better than that of HVAT and HV-HAAT (Z=2.817 and 1.987, P＜0.05). Conclusion Compared with CEUS, VTQ technique has better diagnostic efficacy in assessing the degree of chronic hepatitis liver fibrosis.

Key words: hepatitis B, chronic, liver cirrhosis, elasticity imaging techniques, contrast-enhanced ultrasonography, virtual touch tissue quantitfication