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用于评估乙型病毒性肝炎肝纤维化的声学结构量化与点剪切波速度测量对比

Acoustic Structure Quantification Versus Point Shear Wave Speed Measurement for the Assessment of Liver Fibrosis in Viral Hepatitis B.

作者信息

Liu Jianxue, Ren Wei, Ai Hong, Dun Guoliang, Ji Yonghao, Zhang Yaoren, Wan Qinyun, Lin Shumei

机构信息

Department of Infectious Disease, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Shaanxi, China; Department of Ultrasonography, Baoji Central Hospital, Baoji, China.

Department of Infectious Disease, Baoji Central Hospital, Baoji, China.

出版信息

Ultrasound Med Biol. 2018 Jun;44(6):1177-1186. doi: 10.1016/j.ultrasmedbio.2018.02.010. Epub 2018 Mar 30.

Abstract

This study was conducted to evaluate the value of acoustic structure quantification (ASQ) technology versus that of point shear wave speed measurement (PSWSM) imaging technology for the assessment of liver fibrosis stage. A total of 104 patients with chronic hepatitis B (CHB) and 30 healthy control patients underwent ASQ and PSWSM examinations. Seven quantitative parameters were obtained from ASQ, and a principal component analysis was used to establish the integrative indicators. A quantitative parameter, known as the shear wave speed (SWS, m/s), was obtained from the PSWSM. The METAVIR scores for the assessment of pathologic liver fibrosis were used as a benchmark. Liver fibrosis stages exhibited a good correlation with the integrative indicators and SWS (r = 0.682, p <0.001; r = 0.651, p <0.001). The areas under the receiver operating characteristic curves for ASQ and PSWSM were 0.705 and 0.854 for mild liver fibrosis (F ≥ 1, p = 0.045), 0.813 and 0.743 for significant liver fibrosis (F ≥ 2, p = 0.115), 0.839 and 0.857 for severe liver fibrosis (F ≥ 3, p = 0.417) and 0.874 and 0.971 for liver cirrhosis (F = 4, p = 0.016), respectively. In conclusion, both ASQ and PSWSM were promising ultrasonic methods for assessing liver fibrosis in patients with CHB; however, PSWSM was more valuable for identifying mild liver fibrosis (F ≥ 1) and cirrhosis (F = 4) than ASQ, and the combination of PSWSM and ASQ improved the accuracy of diagnosing severe liver fibrosis (F ≥ 3).

摘要

本研究旨在评估声学结构量化(ASQ)技术与点剪切波速度测量(PSWSM)成像技术在评估肝纤维化分期方面的价值。共有104例慢性乙型肝炎(CHB)患者和30例健康对照者接受了ASQ和PSWSM检查。从ASQ中获得了七个定量参数,并使用主成分分析建立综合指标。从PSWSM中获得了一个名为剪切波速度(SWS,m/s)的定量参数。用于评估病理性肝纤维化的METAVIR评分用作基准。肝纤维化分期与综合指标和SWS均呈现良好的相关性(r = 0.682,p <0.001;r = 0.651,p <0.001)。对于轻度肝纤维化(F≥1,p = 0.045),ASQ和PSWSM的受试者工作特征曲线下面积分别为0.705和0.854;对于显著肝纤维化(F≥2,p = 0.115),分别为0.813和0.743;对于重度肝纤维化(F≥3,p = 0.417),分别为0.839和0.857;对于肝硬化(F = 4,p = 0.016),分别为0.874和0.971。总之,ASQ和PSWSM都是评估CHB患者肝纤维化的有前景的超声方法;然而,PSWSM在识别轻度肝纤维化(F≥1)和肝硬化(F = 4)方面比ASQ更有价值,并且PSWSM与ASQ联合使用可提高诊断重度肝纤维化(F≥3)的准确性。

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