Sporea Ioan, Sirli Roxana, Popescu Alina, Danilă Mirela
Department of Gastroenterology and Hepatology, Victor Babes University of Medicine and Pharmacy Timişoara, str. Snagov nr. 13, 300482 Timisoara, Romania.
Med Ultrason. 2010 Mar;12(1):26-31.
to assess the accuracy of transient elastography (TE) and Acoustic Radiation Force Impulse (ARFI) for liver fibrosis assessment, as compared to percutaneous liver biopsy (LB) in patients with chronic hepatitis.
Our study included 71 patients (P) (54 with HCV and 17 with HBV chronic hepatitis) in which we compared TE and ARFI to the LB (evaluated according to the Metavir scoring system).
On LB, from the 71P, 6P (8.4%) had F1, 25P (35.2%) had F2, 24P (33.8%) had F3 and 16P (22.5%) had F4. A direct, strong, linear correlation (Spearman r=0.707) was found between TE measurements and fibrosis (p<0.0001) and a weaker one, between ARFI and fibrosis (rho=0.469; p<0.0001). TE measurements were also correlated with ARFI measurements r=0.532, p<0.0001. By comparing the AUROC curves, TE and ARFI had similar predictive values for the presence of significant fibrosis (F greater or equal to 2 Metavir): AUROC ARFI=0.649, AUROC TE=0.731 (p=0.476); and cirrhosis (F=4 Metavir): AUROC ARFI=0.868, AUROC TE= 0.936 (p=0.294)
LS measurements assessed by means of TE correlate better than those assessed by means of ARFI to the histological fibrosis in patients with HBV and HCV chronic hepatitis. Both methods have excellent predictive values for the presence of cirrhosis.
与慢性肝炎患者的经皮肝活检（LB）相比，评估瞬时弹性成像（TE）和声学辐射力脉冲（ARFI）用于肝纤维化评估的准确性。
我们的研究纳入了71例患者（P）（54例丙型肝炎病毒[HCV]慢性肝炎患者和17例乙型肝炎病毒[HBV]慢性肝炎患者），我们将TE和ARFI与LB进行比较（根据梅塔维评分系统评估）。
在LB检查中，71例患者中，6例（8.4%）为F1，25例（35.2%）为F2，24例（33.8%）为F3，16例（22.5%）为F4。发现TE测量值与纤维化之间存在直接、强烈的线性相关性（斯皮尔曼r = 0.707）（p < 0.0001），而ARFI与纤维化之间的相关性较弱（rho = 0.469；p < 0.0001）。TE测量值也与ARFI测量值相关，r = 0.532，p < 0.0001。通过比较曲线下面积（AUROC）曲线，TE和ARFI对显著纤维化（F大于或等于2梅塔维）的存在具有相似的预测价值：ARFI的AUROC = 0.649，TE的AUROC = 0.731（p = 0.476）；对于肝硬化（F = 4梅塔维）：ARFI的AUROC = 0.868，TE的AUROC = 0.936（p = 0.294）
在HBV和HCV慢性肝炎患者中，通过TE评估的肝脏硬度（LS）测量值与组织学纤维化的相关性优于通过ARFI评估的测量值。两种方法对肝硬化的存在均具有出色的预测价值。
