Institut Langevin, ESPCI ParisTech, PSL University, CNRS UMR7587, INSERM U979, Paris, France.
Institut Langevin, ESPCI ParisTech, PSL University, CNRS UMR7587, INSERM U979, Paris, France.
J Hepatol. 2015 Feb;62(2):317-24. doi: 10.1016/j.jhep.2014.09.020. Epub 2014 Sep 22.
BACKGROUND & AIMS: Quantitative shear wave elastography was shown to be an effective tool for the non-invasive diagnosis and staging of chronic liver diseases. The liver shear modulus, estimated from the propagation velocity of shear waves, is correlated to the degree of fibrosis and can therefore be used for the non-invasive staging of fibrosis.
We performed a clinical prospective study in a total of 120 patients with various chronic liver diseases to compare the accuracy of supersonic shear imaging (SSI), a technique based on acoustic radiation and ultrafast ultrasound imaging, to 1D transient elastography (FibroScan) for the staging and grading of fibrosis as assessed by liver biopsy. Since shear wave propagation spectroscopy can also provide additional mechanical information on soft tissues, such as viscosity, we also investigated those new mechanical parameters as possible predictors of fibrosis, steatosis, and disease activity.
SSI was successfully performed in 98.3% of patients and it was shown to be as accurate as FibroScan for the staging of fibrosis both for the whole population (N=120) and for the subgroup with viral hepatitis (n=70) (AUC=0.85 [0.77-0.96] and 0.89 [0.81-0.97] for significant fibrosis, AUC=0.90 [0.83-0.97] and 0.87 [0.75-0.98] for cirrhosis, with respect to SSI [n=68/70] and FibroScan [n=66/68]). Viscosity could also be used to stage the degree of fibrosis (AUC=0.76 [0.64-0.87] for significant fibrosis and AUC=0.87 [0.74-0.99] for cirrhosis), for the subgroup of patients with viral hepatitis (n=67/70) but was a poor predictor of disease activity and steatosis levels.
Supersonic shear imaging is a robust technique for the staging of liver fibrosis. Liver viscosity was found to be correlated with fibrosis but not to steatosis or disease activity.
定量剪切波弹性成像已被证明是一种用于慢性肝病的非侵入性诊断和分期的有效工具。从剪切波传播速度估计得出的肝脏剪切模量与纤维化程度相关，因此可用于纤维化的非侵入性分期。
我们对 120 例患有各种慢性肝病的患者进行了一项临床前瞻性研究，比较了基于声辐射和超快超声成像的超声剪切波成像（SSI）技术与 1 维瞬态弹性成像（FibroScan）在评估肝活检纤维化分期和分级方面的准确性。由于剪切波传播光谱还可以提供有关软组织的额外机械信息，如粘度，我们还研究了这些新的机械参数作为纤维化、脂肪变性和疾病活动的可能预测因子。
SSI 在 98.3%的患者中成功进行，结果表明，SSI 在整个人群（N=120）和病毒性肝炎亚组（n=70）中，对纤维化分期与 FibroScan 一样准确（有显著纤维化的 AUC=0.85[0.77-0.96]和 0.89[0.81-0.97]，肝硬化的 AUC=0.90[0.83-0.97]和 0.87[0.75-0.98]，相对于 SSI[n=68/70]和 FibroScan[n=66/68]）。粘度也可用于分期纤维化程度（有显著纤维化的 AUC=0.76[0.64-0.87]和肝硬化的 AUC=0.87[0.74-0.99]），用于病毒性肝炎亚组（n=67/70）的患者，但对疾病活动度和脂肪变性水平的预测能力较差。
超声剪切波成像技术是一种用于分期纤维化的稳健技术。发现肝脏粘度与纤维化相关，但与脂肪变性或疾病活动无关。
