Department of Diagnostic Ultrasound, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China.
Department of Diagnostic Ultrasound, First Affiliated Hospital of Guangxi Medical University, Guangxi, China.
Clin Radiol. 2014 Feb;69(2):194-9. doi: 10.1016/j.crad.2013.10.003. Epub 2013 Nov 26.
To evaluate the utility of the elastic ratio calculated using real-time tissue elastography for assessing liver fibrosis in patients with chronic hepatitis B (CHB).
Ninety-six patients with CHB were enrolled between September 2012 and August 2013. The elastic ratio of the liver for the intrahepatic venous small vessel was calculated to measure liver stiffness. Diagnostic performance of the elastic ratio and aminotransferase-to-platelet ratio index (APRI) were compared with histological fibrosis stage at liver biopsy. In addition, 45 healthy adult volunteers were participated in intra- and interobserver reliability studies.
There was no significant influence of hepatitis B e antigen (HBeAg) status or hepatitis B virus DNA levels on the elastic ratio measurements in CHB patients. The elastic ratio was significantly correlated with histological fibrosis stage (r = 0.873, p < 0.001). Cut-off values were 2.62 for stage 2 and over (S ≥ 2), 3.20 for state 3 and over, and 3.86 for stage 4, respectively. The areas under the receiver operating characteristic (ROC) curves for elastic ratio and APRI diagnosis of significant fibrosis (S ≥ 2) was 0.91 (95% CI: 0.84-0.98) and 0.71 (95% CI: 0.57-0.86), and 0.94 (95% CI: 0.89-0.99) and 0.81 (95% CI: 0.71-0.91) for cirrhosis (S = 4), respectively. The elastic ratio measurements had good reproducibility: 0.838 for intra-observer reliability and 0.805 for inter-observer reliability, respectively (p < 0.001).
Elastic ratio determined using real-time tissue elastography was an accurate and reproducible method for evaluating liver fibrosis in patients with CHB.
评估实时组织弹性成像计算的弹性比值在评估慢性乙型肝炎（CHB）患者肝纤维化中的应用价值。
2012 年 9 月至 2013 年 8 月期间共纳入 96 例 CHB 患者。计算肝内小静脉弹性比值以测量肝硬度。将弹性比值和天冬氨酸转氨酶/血小板比值指数（APRI）与肝活检的组织学纤维化分期进行比较。此外，还招募了 45 名健康成年志愿者进行观察者内和观察者间可靠性研究。
乙型肝炎 e 抗原（HBeAg）状态或乙型肝炎病毒 DNA 水平对 CHB 患者的弹性比值测量无显著影响。弹性比值与组织学纤维化分期显著相关（r = 0.873，p < 0.001）。截断值分别为 2.62 用于 S ≥ 2 期，3.20 用于 S ≥ 3 期，3.86 用于 S = 4 期。弹性比值和 APRI 诊断显著纤维化（S ≥ 2）的受试者工作特征（ROC）曲线下面积分别为 0.91（95%可信区间：0.84-0.98）和 0.71（95%可信区间：0.57-0.86），以及 0.94（95%可信区间：0.89-0.99）和 0.81（95%可信区间：0.71-0.91）用于肝硬化（S = 4）。弹性比值测量具有良好的可重复性：观察者内可靠性为 0.838，观察者间可靠性为 0.805（均 p < 0.001）。
实时组织弹性成像测定的弹性比值是一种评估 CHB 患者肝纤维化的准确且可重复的方法。
