Sigrist Rosa M S, El Kaffas Ahmed, Jeffrey R Brooke, Rosenberg Jarrett, Willmann Jürgen K
Department of Radiology, Molecular Imaging Program at Stanford, School of Medicine, Stanford University, Stanford, California.
Department of Radiology, Molecular Imaging Program at Stanford, School of Medicine, Stanford University, Stanford, California.
Ultrasound Med Biol. 2017 Dec;43(12):2774-2782. doi: 10.1016/j.ultrasmedbio.2017.08.934. Epub 2017 Sep 28.
Ultrasound-based shear wave elastography (SWE) has recently gained substantial attention for non-invasive assessment of liver fibrosis. The purpose of this study was to perform an intra-individual comparison between 2-D shear wave elastography (2-D-SWE with a GE system) and Virtual Touch Tissue Quantification (VTTQ with a Siemens system) to assess whether these can be used interchangeably to grade fibrosis. Ninety-three patients (51 men, 42 women; mean age, 54 y) with liver disease of various etiologies (hepatitis B virus = 47, hepatitis C virus = 22; alcohol = 6, non-alcoholic steatohepatitis = 5, other = 13) were included. Using published system-specific shear wave speed cutoff values, liver fibrosis was classified into clinically non-significant (F0/F1) and significant (≥F2) fibrosis. Results indicated that intra-modality repeatability was excellent for both techniques (GE 2-D-SWE: intra-class correlation coefficient = 0.89 [0.84-0.93]; VTTQ: intra-class correlation coefficient = 0.90 [0.86-0.93]). Intra-modality classification agreement for fibrosis grading was good to excellent (GE 2-D-SWE: κ = 0.65, VTTQ: κ = 0.82). However, inter-modality agreement for fibrosis grading was only fair (κ = 0.31) using published system-specific shear wave speed cutoff values of fibrosis. In conclusion, although both GE 2-D-SWE and Siemens VTTQ exhibit good to excellent intra-modality repeatability, inter-modality agreement is only fair, suggesting that these should not be used interchangeably.
基于超声的剪切波弹性成像(SWE)最近在肝纤维化的无创评估方面受到了广泛关注。本研究的目的是在个体内部比较二维剪切波弹性成像(GE系统的二维SWE)和虚拟触诊组织定量(西门子系统的VTTQ),以评估它们是否可以互换使用来对纤维化进行分级。纳入了93例患有各种病因肝病的患者(51名男性,42名女性;平均年龄54岁)(乙型肝炎病毒 = 47例,丙型肝炎病毒 = 22例;酒精性 = 6例,非酒精性脂肪性肝炎 = 5例,其他 = 13例)。使用已发表的特定系统剪切波速度临界值,将肝纤维化分为临床无显著意义(F0/F1)和有显著意义(≥F2)的纤维化。结果表明,两种技术的模态内重复性都非常好(GE二维SWE:组内相关系数 = 0.89 [0.84 - 0.93];VTTQ:组内相关系数 = 0.90 [0.86 - 0.93])。纤维化分级的模态内分类一致性良好至优秀(GE二维SWE:κ = 0.65,VTTQ:κ = 0.82)。然而,使用已发表的特定系统纤维化剪切波速度临界值,纤维化分级的模态间一致性仅为中等(κ = 0.31)。总之,尽管GE二维SWE和西门子VTTQ都表现出良好至优秀的模态内重复性,但模态间一致性仅为中等,这表明它们不应互换使用。