Zeng Jie, Zheng Jian, Huang Zeping, Chen Shigao, Liu Jing, Wu Tao, Zheng Rongqin, Lu Mingde
Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou, China.
Department of Medical Ultrasonics, Sun Yat-Sen University Tungwah Hospital, Dongguan, China.
Ultrasound Med Biol. 2017 Aug;43(8):1563-1570. doi: 10.1016/j.ultrasmedbio.2017.03.014. Epub 2017 May 5.
This study compared 2-D shear wave elastography (SWE) and transient elastography (TE) for liver fibrosis staging in patients with chronic hepatitis B (CHB) infection using liver biopsy as the reference standard. Patients with CHB infection who underwent liver biopsy were consecutively included. After exclusions, 257 patients were analyzed. Two-dimensional SWE resulted in a significantly higher rate of reliable measurements (98.1%, 252/257) than TE (93.0%, 239/257) (p = 0.011). Liver stiffness measurements of the two examinations exhibited a strong correlation (r = 0.835, p < 0.001). In patients given a confirmed histologic diagnosis, Spearman's rank coefficients were 0.520 in stage F0 (p < 0.001), 0.684 in stage F1 (p < 0.001), 0.777 in stage F2 (p < 0.001), 0.672 in stage F3 (p < 0.001) and 0.755 in stage F4 (p < 0.001). There were no significant differences between the areas under the receiver operating characteristic (ROC) curves of 2-D SWE and TE for liver fibrosis staging (all p values > 0.05). Two-dimensional SWE had diagnostic accuracy comparable to that of TE for liver fibrosis staging. The measurements that the two techniques provide are not interchangeable.
本研究以肝活检为参考标准,比较了二维剪切波弹性成像(SWE)和瞬时弹性成像(TE)在慢性乙型肝炎(CHB)感染患者肝纤维化分期中的应用。连续纳入接受肝活检的CHB感染患者。排除后,对257例患者进行了分析。二维SWE的可靠测量率(98.1%,252/257)显著高于TE(93.0%,239/257)(p = 0.011)。两种检查的肝脏硬度测量结果显示出很强的相关性(r = 0.835,p < 0.001)。在组织学诊断得到证实的患者中,F0期的Spearman等级系数为0.520(p < 0.001),F1期为0.684(p < 0.001),F2期为0.777(p < 0.001),F3期为0.672(p < 0.001),F4期为0.755(p < 0.001)。二维SWE和TE用于肝纤维化分期的受试者操作特征(ROC)曲线下面积之间无显著差异(所有p值> 0.05)。二维SWE在肝纤维化分期方面的诊断准确性与TE相当。两种技术提供的测量结果不可互换。