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二维剪切波弹性成像与瞬时弹性成像在评估慢性乙型肝炎肝纤维化中的比较

Comparison of 2-D Shear Wave Elastography and Transient Elastography for Assessing Liver Fibrosis in Chronic Hepatitis B.

作者信息

Zeng Jie, Zheng Jian, Huang Zeping, Chen Shigao, Liu Jing, Wu Tao, Zheng Rongqin, Lu Mingde

机构信息

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.

出版信息

Ultrasound Med Biol. 2017 Aug;43(8):1563-1570. doi: 10.1016/j.ultrasmedbio.2017.03.014. Epub 2017 May 5.

Abstract

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.

摘要

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。

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