FibroScan S2（儿科）探头与 M 探头在慢性肝病的小成人肝脏硬度测量中的可行性和可靠性比较。
Feasibility and reliability of the FibroScan S2 (pediatric) probe compared with the M probe for liver stiffness measurement in small adults with chronic liver disease.
机构信息
Liver Unit, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada T2N 4Z6.
出版信息
Ann Hepatol. 2013 Jan-Feb;12(1):100-7.
BACKGROUND
The success of liver stiffness measurement (LSM) by transient elastography (TE, FibroScan) is influenced by anthropometric factors. In smaller adults, the M probe may fail due to narrow intercostals spaces and rib interference. We aimed to compare LSM using the FibroScan S2 (pediatric) probe with the M probe in small adults with chronic liver disease.
MATERIAL AND METHODS
In this prospective study, 41 liver disease patients and 18 controls with a thoracic perimeter ≤ 75 cm underwent LSM using the FibroScan M and S2 probes. TE failure was defined as no valid LSMs and unreliable examinations as < 10 valid LSMs, an interquartile range (IQR)/LSM > 30%, or success rate < 60%.
RESULTS
TE failure was not observed and reliability did not differ between the M and S2 probes (86% vs. 95%; P = 0.20). Liver stiffness measured using the M and S2 probes was highly correlated (ρ = 0.81; P < 0.0005) and median liver stiffness did not differ between probes (4.5 vs. 4.4 kPa; P = 0.10). However, in participants with a skin-capsular distance ≥ 15 mm, median liver stiffness was higher using the S2 probe (5.5 vs. 4.9 kPa; P = 0.008). When compared with validated liver stiffness cut-offs, the S2 probe would have overestimated the stage of fibrosis compared with the M probe in 10% of patients.
CONCLUSIONS
The FibroScan S2 probe does not improve the feasibility of LSM in adults of smaller stature and may overestimate liver stiffness compared with the M probe. The FibroScan M probe should remain the preferred tool for LSM in small adults with chronic liver disease.
背景
瞬时弹性成像（TE，FibroScan）的肝硬度测量（LSM）的成功受人体测量因素的影响。在体型较小的成年人中，由于肋间空间较窄和肋骨干扰，M 探头可能无法使用。我们旨在比较 FibroScan S2（儿科）探头与 M 探头在慢性肝病小成年人中的 LSM 应用。
材料和方法
在这项前瞻性研究中，41 名肝脏疾病患者和 18 名胸廓周长≤75cm 的对照组接受了 FibroScan M 和 S2 探头的 LSM。TE 失败定义为无有效 LSM 和不可靠检查（<10 个有效 LSM、IQR/LSM>30%或成功率<60%）。
结果
未观察到 TE 失败，M 和 S2 探头的可靠性无差异（86%与 95%；P=0.20）。M 和 S2 探头测量的肝硬度高度相关（ρ=0.81；P<0.0005），探头之间的肝硬度中位数无差异（4.5 与 4.4kPa；P=0.10）。然而，在皮肤-包膜距离≥15mm 的参与者中，S2 探头的肝硬度中位数较高（5.5 与 4.9kPa；P=0.008）。与验证的肝硬度临界值相比，在 10%的患者中，S2 探头与 M 探头相比，可能高估了纤维化的分期。
结论
FibroScan S2 探头并不能提高体型较小的成年人 LSM 的可行性，与 M 探头相比，S2 探头可能高估肝硬度。对于慢性肝病的小成年人，FibroScan M 探头应仍然是 LSM 的首选工具。
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