Department of Internal Medicine, J.W. Goethe-University Hospital, and Institute of Biostatistics and Mathematical Modelling, Faculty of Medicine, J.W. Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
Eur J Radiol. 2012 Mar;81(3):e325-31. doi: 10.1016/j.ejrad.2011.10.029. Epub 2011 Nov 26.
Transient elastography (TE) and acoustic radiation force impulse (ARFI)-imaging have shown promising results for the staging of liver fibrosis.
The aim of the present study was to compare ARFI of the left and right liver lobe with TE using the standard and obese probes for the diagnosis of liver fibrosis in NAFL/NASH. In addition, liver steatosis is evaluated using the novel controlled attenuation parameter (CAP).
Sixty-one patients with NAFLD/NASH were included in the study. All patients received TE with both probes, ARFI of both liver lobes and CAP. The results were compared with liver histology.
57 patients were included in the final analysis. The diagnostic accuracy for TE measurements with the M-and XL-probe and for ARFI of the right and left liver lobe was 0.73, 0.84, 0.71 and 0.60 for the diagnosis of severe fibrosis, and 0.93, 0.93, 0.74 and 0.90 for the diagnosis of cirrhosis, respectively. No significant difference of results was observed between TE and ARFI in the subgroup of patients with reliable TE-measurement when taking into account the best results of both methods. However, while a significant correlation could be found for TE with histological liver fibrosis, the correlation of ARFI with liver fibrosis was not statistically significant. A significant correlation was found for CAP with histological steatosis (r=0.49, p<0.001).
No significant difference in diagnostic accuracy for the non-invasive assessment of liver fibrosis was found for transient elastography and ARFI. Nevertheless TE significantly correlated with liver fibrosis while ARFI did not. CAP enables the non-invasive assessment of steatosis.
瞬时弹性成像（TE）和声辐射力脉冲成像（ARFI）在肝纤维化分期方面显示出良好的结果。
本研究旨在比较使用标准和肥胖探头的左、右肝 ARFI 与 TE 对非酒精性脂肪性肝病/非酒精性脂肪性肝炎（NAFL/NASH）患者肝纤维化的诊断价值。此外，使用新的受控衰减参数（CAP）评估肝脏脂肪变性。
本研究纳入 61 例 NAFLD/NASH 患者。所有患者均接受 TE 检查，包括左、右探头，以及 ARFI 和 CAP。结果与肝组织学进行比较。
最终有 57 例患者纳入分析。M 探头和 XL 探头 TE 测量以及右、左肝 ARFI 对严重纤维化的诊断准确率分别为 0.73、0.84、0.71 和 0.60，对肝硬化的诊断准确率分别为 0.93、0.93、0.74 和 0.90。在考虑两种方法最佳结果的情况下，对于 TE 测量可靠的患者亚组，TE 和 ARFI 的结果之间没有显著差异。然而，TE 与肝纤维化之间存在显著相关性，而 ARFI 与肝纤维化之间无统计学相关性。CAP 与组织学脂肪变性之间存在显著相关性（r=0.49，p<0.001）。
在评估肝纤维化方面，瞬时弹性成像和 ARFI 的诊断准确性没有显著差异。然而，TE 与肝纤维化显著相关，而 ARFI 则没有。CAP 可用于评估脂肪变性。
