Juárez-Hernández Eva, Uribe-Ramos Martha Helena, Ramos-Ostos Martha Helena, López-Ramírez Angélica Yanine, Ornelas-Arroyo Sofía, Romero-Flores Juan Luis, Méndez-Sánchez Nahúm, Uribe Misael, Chávez-Tapia Norberto C
Obesity and Digestive Diseases Unit, Medica Sur Clinic and Foundation, Puente de Piedra 150, Col. Toriello Guerra, Tlalpan, 14050, Mexico City, Mexico,
Dig Dis Sci. 2015 Jul;60(7):2177-82. doi: 10.1007/s10620-015-3611-2. Epub 2015 Mar 11.
Transient elastography is a noninvasive method for the evaluation of fibrosis in chronic liver disease. However, its reliability is variable, and the factors associated with its accuracy have not been identified completely.
To identify the factors associated with the reliability of transient elastography.
A total of 2033 transient elastography measurements were taken from March 2009 to October 2013. Reliability was determined according to the interquartile range/median (IQR/M < 0.30 = reliable; IQR/M < 0.10 = very reliable). Other indicators such as the percentage of successful measurements (>60 %), time of performance, and probe size were recorded. Potential factors that could affect the reliability of the procedure were analyzed using multivariate logistic regression.
Slightly less than 5 % of the measurements were unsuccessful, and 83 % of the successful measurements were found to be reliable. Factors associated with an unsuccessful measurement were female gender, incorrect probe size, and the presence of HCV infection. Unreliable measurements were associated with use of the procedure as part of a clinical study and success rate. Very reliable evaluations were associated with >10 measurements, the presence of chronic hepatic disease, and a success rate of >60 %.
The operator and clinical and anthropometric characteristics are factors that influence the success and reliability of transient elastography. Improvements in the quality of the procedure are needed to provide better diagnostic accuracy in clinical practice.
瞬时弹性成像术是评估慢性肝病纤维化的一种非侵入性方法。然而，其可靠性存在差异，且与准确性相关的因素尚未完全明确。
确定与瞬时弹性成像术可靠性相关的因素。
2009年3月至2013年10月共进行了2033次瞬时弹性成像测量。根据四分位数间距/中位数（IQR/M < 0.30为可靠；IQR/M < 0.10为非常可靠）来确定可靠性。记录其他指标，如成功测量的百分比（>60%）、操作时间和探头尺寸。使用多因素逻辑回归分析可能影响该检查可靠性的潜在因素。
略少于5%的测量未成功，83%的成功测量结果可靠。与测量未成功相关的因素为女性、探头尺寸不正确以及存在丙型肝炎病毒感染。不可靠的测量与作为临床研究一部分进行该检查以及成功率有关。非常可靠的评估与进行超过10次测量、存在慢性肝病以及成功率>60%有关。
操作者以及临床和人体测量学特征是影响瞬时弹性成像术成功与可靠性的因素。需要提高该检查的质量，以便在临床实践中提供更好的诊断准确性。
