基于传播的可靠性评估的二维剪切波弹性成像在肝纤维化和门静脉高压分级中的应用
Two-dimensional shear wave elastography with propagation-based reliability assessment for grading hepatic fibrosis and portal hypertension.
作者信息
Maruyama Hitoshi, Kobayashi Kazufumi, Kiyono Soichiro, Sekimoto Tadashi, Kanda Tatsuo, Yokosuka Osamu
机构信息
Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
出版信息
J Hepatobiliary Pancreat Sci. 2016 Sep;23(9):595-602. doi: 10.1002/jhbp.379. Epub 2016 Aug 24.
BACKGROUND
The aim of the present study was to examine the diagnostic ability of two-dimensional shear wave elastography (2D-SWE) with propagation-based reliability for grading of hepatic fibrosis and portal hypertension.
METHODS
This prospective study (UMIN000022838) consisted of 135 subjects. Phase I (n = 40) examined the effect of standard deviation (SD)/median as the reliability criterion of 2D-SWE, and phase II (n = 95) compared the diagnostic ability of 2D-SWE under the best SD/median value and transient elastography (TE).
RESULTS
Phase I reported 0.49 as a best cut-off SD/median value. In phase II, the elasticity showed a correlation between the 2D-SWE and TE (r = 0.88, P < 0.001). The area under the receiver operating characteristic curve (AUROC) was comparable between the 2D-SWE and TE (0.936 and 0.948 for chronic hepatitis, P = 0.34; 0.939 and 0.956 for cirrhosis, P = 0.25). The hepatic venous pressure gradient showed a positive correlation with the 2D-SWE (r = 0.435, P = 0.043) and TE (r = 0.378, P = 0.083) in 22 patients. The AUROC was comparable between the 2D-SWE (0.844 for ≥10 mmHg, 0.838 for ≥12 mmHg) and TE (0.781 for ≥10 mmHg, P = 0.484; 0.800 for ≥12 mmHg, P = 0.589).
CONCLUSIONS
2D-SWE is promising for the assessment of the grade of hepatic fibrosis and portal hypertension, with the SD/median value as a reliability criterion.
背景
本研究旨在探讨基于传播可靠性的二维剪切波弹性成像（2D-SWE）对肝纤维化和门静脉高压分级的诊断能力。
方法
这项前瞻性研究（UMIN000022838）包括135名受试者。第一阶段（n = 40）研究标准差（SD）/中位数作为2D-SWE可靠性标准的效果，第二阶段（n = 95）比较在最佳SD/中位数下2D-SWE与瞬时弹性成像（TE）的诊断能力。
结果
第一阶段报告0.49为最佳截断SD/中位数。在第二阶段，弹性显示2D-SWE与TE之间存在相关性（r = 0.88，P < 0.001）。2D-SWE和TE之间的受试者工作特征曲线下面积（AUROC）相当（慢性肝炎分别为0.936和0.948，P = 0.34；肝硬化分别为0.939和0.956，P = 0.25）。22例患者的肝静脉压力梯度与2D-SWE（r = 0.435，P = 0.043）和TE（r = 0.378，P = 0.083）呈正相关。2D-SWE（≥10 mmHg时为0.844，≥12 mmHg时为0.838）和TE（≥10 mmHg时为0.781，P = 0.484；≥12 mmHg时为0.800，P = 0.589）之间的AUROC相当。
结论
以SD/中位数为可靠性标准，2D-SWE在评估肝纤维化和门静脉高压分级方面具有前景。
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