Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan.
Liver Int. 2010 Apr;30(4):538-45. doi: 10.1111/j.1478-3231.2009.02130.x. Epub 2009 Oct 27.
Acoustic radiation force impulse (ARFI) is a new technology integrated into conventional B-mode ultrasonography. ARFI is used to evaluate tissue stiffness in several organs, but this method has not been applied for liver fibrosis.
The aim of this study was to determine whether ARFI elastography is useful for the evaluation of liver fibrosis.
This study enrolled 55 consecutive patients with chronic liver disease who underwent a liver biopsy for histological assessment of liver fibrosis by the Metavir scoring system. Liver stiffness of the 55 patients and 25 healthy volunteers was evaluated by ARFI elastography and was expressed as the shear wave velocity. Cut-off values were determined using receiver-operating characteristic (ROC) curves.
Histological liver fibrosis was evaluated by Metavir scoring; F0: six cases, F1: 14 cases, F2: nine cases, F3: nine cases and F4: 17 cases. Liver stiffness determined by ARFI elastography was correlated with histological liver fibrosis (P<0.0001). The areas under the ROC curves were 0.94 (95% confidence intervals, 0.87-0.99) for F2-F4, 0.94 (0.88-0.99) for F3-F4 and 0.96 (0.91-1.01) for F4. The cut-off values of the shear wave velocity were as follows: >1.34 m/s for F2-F4 (sensitivity 91.4%, specificity 80%); >1.44 m/s for F3-F4 (sensitivity 96.2%, specificity 79.3%); and >1.80 m/s for F4 (sensitivity 94.1%, specificity 86.8%).
Ultrasonic ARFI elastography is a novel, non-invasive and reliable method for the assessment of liver fibrosis in patients with chronic liver disease.
声辐射力脉冲（ARFI）是一种集成于常规 B 型超声的新技术。ARFI 用于评估多个器官的组织硬度，但尚未应用于肝纤维化的评估。
本研究旨在评估声辐射力脉冲弹性成像（ARFI）在肝纤维化评估中的作用。
本研究纳入 55 例连续的慢性肝病患者，所有患者均接受肝脏活检，并通过 Metavir 评分系统进行肝纤维化的组织学评估。采用 ARFI 弹性成像技术评估 55 例患者和 25 例健康志愿者的肝脏硬度，以剪切波速度（SWV）表示。采用受试者工作特征（ROC）曲线确定截断值。
采用 Metavir 评分评估组织学肝纤维化；F0：6 例，F1：14 例，F2：9 例，F3：9 例，F4：17 例。ARFI 弹性成像技术检测的肝脏硬度与组织学肝纤维化显著相关（P<0.0001）。ROC 曲线下面积（AUC）分别为 F2-F4（0.94，95%置信区间：0.87-0.99）、F3-F4（0.94，0.88-0.99）和 F4（0.96，0.91-1.01）。剪切波速度的截断值分别为：F2-F4（1.34 m/s，灵敏度 91.4%，特异性 80%）、F3-F4（1.44 m/s，灵敏度 96.2%，特异性 79.3%）和 F4（1.80 m/s，灵敏度 94.1%，特异性 86.8%）。
超声 ARFI 弹性成像技术是一种新型、无创、可靠的评估慢性肝病患者肝纤维化的方法。
