Hu Xiangdong, Qiu Lanyan, Liu Dong, Qian Linxue
Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Med Ultrason. 2017 Jan 31;19(1):23-31. doi: 10.11152/mu-942.
The purpose of the study was to assess the effect of Acoustic Radiation Force Impulse (ARFI) elastography in the diagnosis of liver fibrosis in chronic hepatitis B and C patients through Meta-analysis.
Four databases (PubMed, the Cochrane Library, WanFang data, and CNKI) were searched. The key words were: ("ARFI" or "acoustic radiation force impulse") combined with "liver fibrosis" and ("chronic hepatitis" or "HBV HCV"). Heterogeneity (I2) was assessed, and its source was analyzed through meta-regression.
21 articles with 2,691 patients were included. The compositeSe=0.79 (95% CI: 0.76-0.83) and Sp=0.86 (95% CI: 0.85-0.88). ARFI elastography showed a better ability to evaluate higherstage liver fibrosis and liver cirrhosis (F=3 and F=4, respectively). For F≥3, Se=0.84 (95% CI: 0.80-0.88, I2=61.37), Sp=0.90 (95% CI: 0.86-0.92, I2=65.10), and AUROC=0.94 (95% CI: 0.91-0.95). Se and Sp and AUROC of F=4 were 0.86 (95% CI: 0.80-0.91, I2=70.67), 0.84 (95% CI: 0.80-0.88, I2=78.94) and 0.91 (95% CI: 0.89-0.94), respectively. Besides, the combined RFI values indicate that CHC patients had higher ARFI values especially in the F3 stage (1.87 [95% CI: 1.67-2.06] and 2.31[95% CI: 2.09-2.52] for CHB and CHC, respectively).
ARFI elastography is accurate and reliable in the diagnosis of CHB- and CHC-induced liver fibrosis and is especially suitable for the evaluation of stages F≥3 and F=4. CHC patients manifest higher ARFI values than CHB patients especially in the F3 stage.
本研究旨在通过Meta分析评估声辐射力脉冲（ARFI）弹性成像技术在慢性乙型和丙型肝炎患者肝纤维化诊断中的作用。
检索了四个数据库（PubMed、Cochrane图书馆、万方数据和中国知网）。关键词为：（“ARFI”或“声辐射力脉冲”）与“肝纤维化”以及（“慢性肝炎”或“HBV HCV”）。评估异质性（I2），并通过Meta回归分析其来源。
纳入21篇文章，共2691例患者。综合灵敏度（Se）=0.79（95%CI：0.76 - 0.83），特异度（Sp）=0.86（95%CI：0.85 - 0.88）。ARFI弹性成像在评估较高阶段肝纤维化和肝硬化（分别为F = 3和F = 4）方面表现出更好的能力。对于F≥3，Se = 0.84（95%CI：0.80 - 0.88，I2 = 61.37），Sp = 0.90（95%CI：0.86 - 0.92，I2 = 65.10），曲线下面积（AUROC）=0.94（95%CI：0.91 - 0.95）。F = 4时的Se、Sp和AUROC分别为0.86（95%CI：0.80 - 0.91，I2 = 70.67）、0.84（95%CI：0.80 - 0.88，I2 = 78.94）和0.91（95%CI：0.89 - 0.94）。此外，合并的RFI值表明，丙型肝炎患者的ARFI值更高，尤其是在F3阶段（慢性乙型肝炎和慢性丙型肝炎患者分别为1.87[95%CI：1.67 - 2.06]和2.31[95%CI：2.09 - 2.52]）。
ARFI弹性成像技术在慢性乙型和丙型肝炎所致肝纤维化的诊断中准确可靠，尤其适用于F≥3和F = 4阶段的评估。丙型肝炎患者的ARFI值高于乙型肝炎患者，尤其是在F3阶段。
