Guerra Juliana Ayres de Alencar Arrais, Trippia Marcus, Pissaia Alcindo, Teixeira Bernardo Corrêa de Almeida, Ivantes Cláudia Alexandra Pontes
Unidade de Gastroenterologia e Hepatologia, Hospital Nossa Senhora das Graças, Curitiba, PR, BR.
Diagnóstico Avançado por Imagem (DAPI), Curitiba, PR, BR.
Arq Gastroenterol. 2015 Jul-Sep;52(3):234-8. doi: 10.1590/S0004-28032015000300015.
Liver biopsy is recommended as the gold standard method for assessing the stage of liver fibrosis in patients with chronic liver disease. However, it is invasive, with potential risks and complications. Elastography is an ultrasound technique that provides information of changes in the liver tissue, evaluating tissue elasticity and acoustic radiation force impulse is one of the available techniques.
The main objective of this study was to evaluate the sensitivity and specificity of acoustic radiation force impulse comparing to liver biopsy to evaluate fibrosis in patients with chronic hepatitis C virus and nonalcoholic fatty liver disease.
Twenty four patients were included, everyone underwent liver biopsy and acoustic radiation force impulse, and the results were compared with values described in the literature by several authors.
In the population of patients with chronic hepatitis C, our data were better correlated with data published by Carmen Fierbinteanu-Braticevici et al., with an accuracy of 82.4%, sensitivity of 71.4% and specificity of 90%. For nonalcoholic fatty liver disease, our data were better correlated with data published by Masato Yoneda et al., with an accuracy of 85.7%, sensitivity 80% and specificity of 100%.
Acoustic radiation force impulse is a method with good accuracy to distinguish initial fibrosis from advanced fibrosis in hepatitis C virus and nonalcoholic fatty liver disease and can replace biopsy in most cases.
肝活检被推荐为评估慢性肝病患者肝纤维化分期的金标准方法。然而，它具有侵入性，存在潜在风险和并发症。弹性成像术是一种超声技术，可提供肝脏组织变化的信息，评估组织弹性，而声辐射力脉冲是可用技术之一。
本研究的主要目的是评估与肝活检相比，声辐射力脉冲评估丙型肝炎病毒慢性感染患者和非酒精性脂肪性肝病患者肝纤维化的敏感性和特异性。
纳入24例患者，每位患者均接受肝活检和声辐射力脉冲检查，并将结果与几位作者在文献中描述的值进行比较。
在丙型肝炎慢性感染患者群体中，我们的数据与Carmen Fierbinteanu-Braticevici等人发表的数据相关性更好，准确率为82.4%，敏感性为71.4%，特异性为90%。对于非酒精性脂肪性肝病，我们的数据与Masato Yoneda等人发表的数据相关性更好，准确率为85.7%，敏感性为80%，特异性为100%。
声辐射力脉冲是一种在区分丙型肝炎病毒和非酒精性脂肪性肝病的早期纤维化与晚期纤维化方面具有良好准确性的方法，在大多数情况下可以替代活检。
