Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy.
Dipartimento delle Insufficienze d'Organo e dei Trapianti, Policlinico S. Orsola-Malpighi, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Liver Int. 2017 Feb;37(2):187-195. doi: 10.1111/liv.13197. Epub 2016 Aug 1.
BACKGROUND & AIMS: Elastography point quantification is a novel non-invasive method for the assessment of liver fibrosis by measuring liver stiffness. The aim of this study was to evaluate the accuracy of elastography point quantification for the diagnosis of liver fibrosis and to assess impact of steatosis on liver stiffness measurement, in a cohort of patients with chronic hepatitis C.
In this single-centre cross-sectional study, 211 consecutive patients with chronic hepatitis C, scheduled for liver biopsy, were examined with the elastography point quantification technology. On the same day, all patients underwent clinical examination, laboratory tests and abdominal ultrasound.
The best cut-offs of liver stiffness measurement were 6.16 kPa for the diagnosis of significant fibrosis (≥S3) and 6.79 kPa for advanced fibrosis (≥S4). Areas under the receiver operating characteristic curve were 0.831 (CI: 0.773-0.880) for significant fibrosis, and 0.954 (CI: 0.916-0.978) for advanced fibrosis. Among patients within the same fibrosis stages (S0-S2 and S3-S6; S0-S3 and S4-S6), mean liver stiffness measurement values were similar in patients with steatosis (≥10% at liver biopsy or detected by ultrasound) compared to those without. Discordance between elastography point quantification and histology were affected by the presence of BMI>30 kg/m (P=.047, CI: 0.136-0.988 and P=.020, CI: 0.083-0.812 respectively).
In patients with chronic hepatitis C, elastography point quantification is an accurate non-invasive method for the diagnosis of significant and advanced fibrosis. The presence of obesity is a risk factor for misclassification of significant and advanced liver fibrosis.
弹性成像点定量是一种通过测量肝脏硬度来评估肝纤维化的新型无创方法。本研究旨在评估弹性成像点定量技术在诊断慢性丙型肝炎患者肝纤维化中的准确性，并评估脂肪变性对肝脏硬度测量的影响。
在这项单中心横断面研究中，对 211 例慢性丙型肝炎患者进行了弹性成像点定量技术检查。同一天，所有患者均进行了临床检查、实验室检查和腹部超声检查。
肝脏硬度测量的最佳截断值为 6.16 kPa 用于诊断显著纤维化（≥S3）和 6.79 kPa 用于诊断晚期纤维化（≥S4）。受试者工作特征曲线下面积分别为 0.831（95%可信区间：0.773-0.880）和 0.954（95%可信区间：0.916-0.978）。在具有相同纤维化阶段（S0-S2 和 S3-S6；S0-S3 和 S4-S6）的患者中，脂肪变性（肝活检或超声检测≥10%）患者的平均肝脏硬度测量值与无脂肪变性患者相似。弹性成像点定量与组织学之间的差异受 BMI>30 kg/m2 的影响（P=0.047，95%可信区间：0.136-0.988 和 P=0.020，95%可信区间：0.083-0.812）。
在慢性丙型肝炎患者中，弹性成像点定量是一种准确的非侵入性方法，可用于诊断显著和晚期纤维化。肥胖是显著和晚期肝纤维化分类错误的危险因素。
