Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuou-ku, Chiba 260-8670, Japan.
Eur Radiol. 2012 May;22(5):1083-90. doi: 10.1007/s00330-011-2346-5. Epub 2011 Dec 30.
To examine the feasibility of perflubutane-based ultrasound for grading hepatic fibrosis.
This prospective study included 202 subjects; main study (controls:33, F0-1:35, F2:26, F3:23, cirrhosis:29) and subsequent study (controls:16, F0-1:7, F2:20, F3:7, cirrhosis:6). Diagnostic abilities for assessing fibrosis grade were compared between contrast findings and FIB4 (age × AST/[platelet count × ALT(0.5)]).
High-power emission produced an intrahepatic band-like structure, and the three-layer appearance was less frequent and monolayer appearance was more frequent in cirrhosis than controls/chronic hepatitis (P < 0.0001). Intensity difference at 15-min phase showed most significant correlation with fibrosis grade (ρ = 0.79, P < 0.0001), and the best areas under the receiver operating characteristic curves are 0.88 for marked fibrosis, 0.95 for advanced fibrosis and 0.97 for cirrhosis, which were significantly higher than those of FIB4, 0.85 for marked fibrosis, 0.89 for advanced fibrosis and 0.90 for cirrhosis. Sensitivity, specificity and efficiency of the intensity difference were 88%, 72% and 81% for marked fibrosis, 85%, 91% and 89% for advanced fibrosis and 97%, 90% and 91% for cirrhosis, respectively. The subsequent study validated the main study results; significant correlation between the intensity difference and the fibrosis grade (ρ = 0.73-0.77, P < 0.0001).
Perflubutane-based ultrasound accurately predicts the grade of hepatic fibrosis.
• The behaviour of intrahepatic microbubbles depends on the severity of hepatic fibrosis. • Layer enhancement pattern simply represents the degree of chronic liver disease. • Parenchymal intensity change due to high-power emission predicts the hepatic fibrosis grade.
探讨基于全氟丁烷的超声在肝纤维化分级中的可行性。
本前瞻性研究纳入 202 例受试者；主要研究（对照组：33 例，F0-1 期：35 例，F2 期：26 例，F3 期：23 例，肝硬化：29 例）和后续研究（对照组：16 例，F0-1 期：7 例，F2 期：20 例，F3 期：7 例，肝硬化：6 例）。对比两种方法（对比发现和 FIB4[年龄×AST/（血小板计数×ALT(0.5)]）在评估纤维化程度方面的诊断能力。
高能发射产生肝内条带状结构，肝硬化与对照组/慢性肝炎相比，三层结构较少见，单层结构较多见（P < 0.0001）。15 分钟时的强度差异与纤维化程度相关性最强（ρ = 0.79，P < 0.0001），受试者工作特征曲线下的最佳面积为 0.88 用于显著纤维化，0.95 用于晚期纤维化，0.97 用于肝硬化，明显高于 FIB4 的 0.85 用于显著纤维化，0.89 用于晚期纤维化和 0.90 用于肝硬化。强度差异的敏感性、特异性和效率分别为 88%、72%和 81%用于显著纤维化，85%、91%和 89%用于晚期纤维化，97%、90%和 91%用于肝硬化。后续研究验证了主要研究结果；强度差异与纤维化程度之间存在显著相关性（ρ = 0.73-0.77，P < 0.0001）。
基于全氟丁烷的超声能准确预测肝纤维化程度。
肝内微泡的行为取决于肝纤维化的严重程度。
层增强模式简单地代表慢性肝病的程度。
高能发射引起的实质强度变化可预测肝纤维化程度。
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