To explore the value of acoustic radiation force pulse (ARFI) imaging in the evaluation of therapeutic effects for drug induced liver injury (DILI) and viral hepatitis (VH).

Seventy-four inpatients diagnosed with DILI or VH at Department of Gastroenterology of the No. 2 Hospital of Baoding from January 2017 to August 2020 who met the inclusion criteria were included in this study. Conventional ultrasound and ARFI examinations were performed for each patient before treatment, one month after treatment, and three months after treatment, and virtual touch tissue quantification (VTQ) values were acquired and recorded. One hundred healthy volunteers were included as controls and VTQ values of the liver were also acquired and recorded.

There were 34 cases of DLIL and 40 cases of VH included in this study. There was no significant difference in VTQ values between the DILI group and HV group before treatment (1.74±0.18 m/s vs 1.70±0.41 m/s, P＞0.05), while they were both significantly higher than those of normal volunteers (1.12±0.16 m/s, P＜0.05). There was no significant difference in VTQ values between one month and three months after treatment in the DILI group (1.14±0.23 m/s vs 1.06±0.40 m/s, P＞0.05), while they were both significantly lower than those before treatment (P＜0.05). There was no significant difference in VTQ values between before treatment and one month after treatment (1.59±0.16 m/s) in the HV group (P＞0.05), while they were both significantly higher than those three months after treatment (1.12±0.23 m/s, P＜0.05). There was a significant difference in VTQ values between DILI group and HV group one month after treatment (P＞0.05).

As a non-invasive and quantitative method, ARFI can assess liver stiffness objectively and observe the stiffness changes in DILI and HV after treatment dynamically. It may provide information about the cause of liver injury according to the patients' recovery cycle.