Department of Gastroenterology and Hepatology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Romania.
Eur J Radiol. 2014 Feb;83(2):268-72. doi: 10.1016/j.ejrad.2013.11.019. Epub 2013 Dec 4.
Acoustic Radiation Force Impulse (ARFI) elastography is a non-invasive technique for liver fibrosis assessment.
To assess the feasibility of ARFI elastography in a large cohort of subjects and to identify factors associated with impossibility to obtain reliable liver stiffness (LS) measurements by means of this technique.
Our retrospective study included 1031 adult subjects with or without chronic liver disease. In each subject LS was assessed by means of ARFI elastography. Failure of ARFI measurements was defined if no valid measurement was obtained after at least 10 shots and unreliable in the following situations: fewer than 10 valid shots; or median value of 10 valid measurements with a success rate (SR)<60% and/or an interquartile range interval (IQR) ≥ 30%.
Failure of LS measurements by means of ARFI was observed in 4 subjects (0.3%), unreliable measurements in 66 subjects (6.4%), so reliable measurements were obtained in 961 subjects (93.3%). In univariant analysis, the following risk factors were associated with failed and unreliable measurements: age over 58 years (OR=0.49; 95% CI 0.30-0.80, p=0.005), male gender (OR=0.58; 95% CI 0.34-0.94, p=0.04), BMI>27.7 kg/m(2) (OR=0.23, 95% CI 0.13-0.41, p<0.0001). In multivariate analysis all the factors mentioned above were independently associated with the risk of failed and unreliable measurements.
Reliable LS measurements by means of ARFI elastography were obtained in 93.3% of cases. Older age, higher BMI and male gender were associated with the risk of failed and unreliable measurements, but their influence is limited as compared with Transient Elastography.
声辐射力脉冲（ARFI）弹性成像是一种用于评估肝纤维化的非侵入性技术。
评估 ARFI 弹性成像在大量研究对象中的可行性，并确定与无法通过该技术获得可靠肝硬度（LS）测量值相关的因素。
我们的回顾性研究包括 1031 名患有或不患有慢性肝病的成年患者。在每个患者中，通过 ARFI 弹性成像评估 LS。如果在至少 10 次射击后未获得有效测量值或在以下情况下测量值不可靠，则定义为 ARFI 测量失败：少于 10 次有效射击；或 10 次有效测量值的中位数（SR）<60%和/或四分位距间隔（IQR）≥30%。
通过 ARFI 进行 LS 测量失败的情况发生在 4 例患者（0.3%）中，不可靠测量的情况发生在 66 例患者（6.4%）中，因此获得了 961 例患者（93.3%）的可靠测量值。在单变量分析中，以下危险因素与失败和不可靠的测量值相关：年龄超过 58 岁（OR=0.49；95%CI 0.30-0.80，p=0.005），男性（OR=0.58；95%CI 0.34-0.94，p=0.04），BMI>27.7 kg/m2（OR=0.23，95%CI 0.13-0.41，p<0.0001）。在多变量分析中，上述所有因素均与失败和不可靠测量值的风险独立相关。
通过 ARFI 弹性成像获得了 93.3%的可靠 LS 测量值。年龄较大、BMI 较高和男性与失败和不可靠测量值的风险相关，但与瞬时弹性成像相比，其影响有限。
