联合弹性成像评估自身免疫性肝炎患者肝脏炎症对肝脏硬度测量的影响

Influence of Liver Inflammation on Liver Stiffness Measurement in Patients with Autoimmune Hepatitis Evaluation by Combinational Elastography.

作者信息

Yada Norihisa, Sakurai Toshiharu, Minami Tomohiro, Arizumi Tadaaki, Takita Masahiro, Hagiwara Satoru, Ida Hiroshi, Ueshima Kazuomi, Nishida Naoshi, Kudo Masatoshi

机构信息

Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.

出版信息

Oncology. 2017;92 Suppl 1:10-15. doi: 10.1159/000451011. Epub 2017 Jan 6.

DOI:10.1159/000451011

PMID:28056459

Abstract

OBJECTIVE

In order to evaluate the influence of liver inflammation on liver stiffness measurement (LSM) by the simultaneous use of shear wave and strain imaging (combinational elastography), shear wave and strain imaging were compared before and after initial therapy for autoimmune hepatitis (AIH).

METHODS

Nine AIH patients initially treated with steroid were enrolled. Transient elastography and real-time tissue elastography were performed just before and 1 month after the start of initial steroid treatment. Blood samples, LSM, and the liver fibrosis index (LFI) were compared.

RESULTS

Aspartate aminotransferase (p = 0.002) and alanine aminotransferase (ALT) (p = 0.015) were significantly decreased after initial treatment. The LSM was 15.5 ± 9.6 kPa at baseline, decreasing to 7.2 ± 2.3 kPa after initial treatment p = 0.034). The LFI was 1.67 ± 0.67 at baseline and 1.61 ± 0.66 after initial treatment; no significant change in LFI was recognized (p = 0.842). Between ΔALT and ΔLSM, a significant regression equation could be calculated as follows: ΔALT = -0.55 + 0.654 × ΔLSM.

CONCLUSIONS

Combinational elastography was useful in evaluating not only the degree of liver fibrosis, but also the degree of liver inflammation in AIH.

摘要

目的

为了通过同时使用剪切波和应变成像（联合弹性成像）来评估肝脏炎症对肝脏硬度测量（LSM）的影响，在自身免疫性肝炎（AIH）初始治疗前后对剪切波和应变成像进行了比较。

方法

纳入9例初始接受类固醇治疗的AIH患者。在初始类固醇治疗开始前及开始后1个月进行瞬时弹性成像和实时组织弹性成像。比较血样、LSM和肝脏纤维化指数（LFI）。

结果

初始治疗后天冬氨酸转氨酶（p = 0.002）和丙氨酸转氨酶（ALT）（p = 0.015）显著降低。LSM在基线时为15.5±9.6 kPa，初始治疗后降至7.2±2.3 kPa（p = 0.034）。LFI在基线时为1.67±0.67，初始治疗后为1.61±0.66；未发现LFI有显著变化（p = 0.842）。在ΔALT和ΔLSM之间，可以计算出如下显著回归方程：ΔALT = -0.55 + 0.654×ΔLSM。