Abstract: Objective To study the value of real-time two-dimensional shear wave elastography(2D-SWE) in the diagnosis of various stages of liver fibrosis in patients with chronic liver disease(CLD). 
Methods Eighty-seven CLD patients with liver fibrosis were selected as the pathological group, and 86 healthy physical examinees during the same period served as the control group. The pathological group was divided into groups according to the stage of liver fibrosis. Both groups received real-time 2D-SWE to compare the liver stiffness measurement(LSM) values of the pathological group and the control group as well as the serological indexes of the pathological group. The correlation between real-time 2D-SWE and the diagnostic efficiency was analyzed. 
Results The LSM values of S1, S2, S3, and S4 were significantly higher than those of the control group, and the value of S4 was significantly higher than that of S0, S1, S2, and S3; the value of S3 was significantly higher than that of S0, S1, and S2, and the value of S2 was significantly higher than that of S0, S1; the value of S1 was significantly higher than that of S0(P＜0.05). After detection, Ⅳ collagen(Ⅳ-C), laminin(LN), serum hyaluronic acid(HA) were significantly higher in S4 than in S0, S1, S2, and S3, and the indicators in S3 were significantly higher than those of S0, S1, and S2; the indicators in S2 were significantly higher than those of S0 and S1; the indicators in S1 were significantly higher than those of S0(P＜0.05). Correlation analysis showed that real-time 2D-SWE was positively correlated with fibrosis staging, Ⅳ-C and HA. According to the pathological results as the gold standard, the AUC results of each pathological stage were 0.800, 0.792, 0.773, and 0.812, respectively; the threshold of S1, S2,S3 and S4 was 80.59, 88.37, 90.75, and 94.57, respectively. 
Conclusion Real-time 2D-SWE can effectively determine the degree of liver fibrosis in patients with CLD, and there is a positive correlation between LSM and the stage of fibrosis.

Key words: liver diseases, liver cirrhosis, elasticity imaging techniques