Sun Xiao-Lan, Liang Li-Wei, Cao Hui, Men Qiong, Hou Ke-Zhu, Chen Zhen, Zhao Ya-E
Xiao-Lan Sun, Department of Ultrasound in Medicine, Shanghai Shidong Hospital, Shanghai 200438, China.
World J Gastroenterol. 2015 Aug 28;21(32):9648-55. doi: 10.3748/wjg.v21.i32.9648.
To evaluate the utility of liver reserve function by acoustic radiation force impulse (ARFI) imaging in patients with liver tumors.
Seventy-six patients with liver tumors were enrolled in this study. Serum biochemical indexes, such as aminotransferase (ALT), aspartate aminotransferase (AST), serum albumin (ALB), total bilirubin (T-Bil), and other indicators were observed. Liver stiffness (LS) was measured by ARFI imaging, measurements were repeated 10 times, and the average value of the results was taken as the final LS value. Indocyanine green (ICG) retention was performed, and ICG-K and ICG-R15 were recorded. Child-Pugh (CP) scores were carried out based on patient's preoperative biochemical tests and physical condition. Correlations among CP scores, ICG-R15, ICG-K and LS values were observed and analyzed using either the Pearson correlation coefficient or the Spearman rank correlation coefficient. Kruskal-Wallis test was used to compare LS values of CP scores, and the receiver-operator characteristic (ROC) curve was used to analyze liver reserve function assessment accuracy.
LS in the ICG-R15 10%-20% group was significantly higher than in the ICG-R15 < 10% group; and the difference was statistically significant (2.19 ± 0.27 vs 1.59 ± 0.32, P < 0.01). LS in the ICG-R15 > 20% group was significantly higher than in the ICG-R15 < 10% group; and the difference was statistically significant (2.92 ± 0.29 vs 1.59 ± 0.32, P < 0.01). The LS value in patients with CP class A was lower than in patients with CP class B (1.57 ± 0.34 vs 1.86 ± 0.27, P < 0.05), while the LS value in patients with CP class B was lower than in patients with CP class C (1.86 ± 0.27 vs 2.47 ± 0.33, P < 0.01). LS was positively correlated with ICG-R15 (r = 0.617, P < 0.01) and CP score (r = 0.772, P < 0.01). Meanwhile, LS was negatively correlated with ICG-K (r = -0.673, P < 0.01). AST, ALT and T-Bil were positively correlated with LS, while ALB was negatively correlated with LS (P < 0.05). The ROC curve revealed that the when the LS value was 2.34 m/s, the Youden index was at its highest point, sensitivity was 69.2% and specificity was 92.1%.
For patients with liver tumors, ARFI imaging is a useful tool for assessing liver reserve function.
评估声辐射力脉冲（ARFI）成像在肝肿瘤患者中评估肝脏储备功能的效用。
本研究纳入76例肝肿瘤患者。观察血清生化指标，如转氨酶（ALT）、天冬氨酸转氨酶（AST）、血清白蛋白（ALB）、总胆红素（T-Bil）及其他指标。采用ARFI成像测量肝脏硬度（LS），重复测量10次，取结果的平均值作为最终LS值。进行吲哚菁绿（ICG）滞留试验，并记录ICG-K和ICG-R15。根据患者术前生化检查和身体状况进行Child-Pugh（CP）评分。使用Pearson相关系数或Spearman秩相关系数观察并分析CP评分、ICG-R15、ICG-K与LS值之间的相关性。采用Kruskal-Wallis检验比较CP评分的LS值，采用受试者操作特征（ROC）曲线分析肝脏储备功能评估的准确性。
ICG-R15为10%-20%组的LS显著高于ICG-R15<10%组；差异有统计学意义（2.19±0.27 vs 1.59±0.32，P<0.01）。ICG-R15>20%组的LS显著高于ICG-R1
