Kettaneh Adrien, Marcellin Patrick, Douvin Catherine, Poupon Raoul, Ziol Marianne, Beaugrand Michel, de Lédinghen Victor
Service de Médecine Interne, Hôpital Saint-Antoine, Assistance Publique/Hôpitaux de Paris, Paris and Université Pierre et Marie Curie, Paris, France.
J Hepatol. 2007 Apr;46(4):628-34. doi: 10.1016/j.jhep.2006.11.010. Epub 2006 Dec 12.
BACKGROUND/AIMS: FibroScan, a non-invasive procedure for the diagnosis of cirrhosis, benefits only patients for which at least 10 valid shots are acquired. We investigated features associated with success rate of shots, and performance of FibroScan for the diagnosis of cirrhosis.
Liver biopsy and stiffness measurement were performed in HCV patients. AUROCs and mixed logistic models evaluated the influence of patient and operator features on the success of shots and the performance for the diagnosis of cirrhosis.
Nine hundred and thirty five (935) patients were included. Success rate of shots decreased with age, and was lower in obese than in other patients. After adjusting for age and obesity, an operator with at least 50 prior FibroScan exams had a higher success rate in shots. FibroScan performance for the diagnosis of cirrhosis was not influenced by the number of valid shots taken into account and by operator skills.
After a rapid training, FibroScan provides a reasonable performance for the diagnosis of cirrhosis that is not influenced substantially by any other feature. More patients will benefit from this procedure with no significant loss in performance if only 5 valid shots are requested. These results should emphasize the use of FibroScan even in non-specialized units.
背景/目的：FibroScan是一种用于诊断肝硬化的非侵入性检查方法，仅对获取至少10次有效检测值的患者有益。我们研究了与检测成功率相关的特征以及FibroScan诊断肝硬化的性能。
对丙型肝炎病毒（HCV）患者进行肝活检和硬度测量。受试者工作特征曲线下面积（AUROCs）和混合逻辑模型评估了患者和操作者特征对检测成功率及肝硬化诊断性能的影响。
纳入935例患者。检测成功率随年龄增长而降低，肥胖患者的检测成功率低于其他患者。在调整年龄和肥胖因素后，既往至少进行过50次FibroScan检查的操作者检测成功率更高。FibroScan诊断肝硬化的性能不受所考虑的有效检测值数量及操作者技能的影响。
经过快速培训后，FibroScan在肝硬化诊断方面具有合理的性能，且不受任何其他特征的显著影响。如果仅要求5次有效检测值，更多患者将从该检查方法中受益，且性能不会有显著损失。这些结果应强调即使在非专科单位也可使用FibroScan。
