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二维剪切波弹性成像在慢性丙型肝炎患者肝纤维化诊断中的准确性

Accuracy of 2D shear wave elastography in the diagnosis of liver fibrosis in patients with chronic hepatitis C.

作者信息

Abe Tamami, Kuroda Hidekatsu, Fujiwara Yudai, Yoshida Yuichi, Miyasaka Akio, Kamiyama Naohisa, Takikawa Yasuhiro

机构信息

Division of Hepatology, Department of Internal Medicine, Iwate Medical University, Morioka, Iwate, 020-8505, Japan.

Ultrasound General Imaging, GE Healthcare, Tokyo, 191-8503, Japan.

出版信息

J Clin Ultrasound. 2018 Jun;46(5):319-327. doi: 10.1002/jcu.22592. Epub 2018 Apr 6.

Abstract

PURPOSE

This prospective study was conducted to assess the diagnostic accuracy of two-dimensional shear wave elastography (2D SWE) in the diagnosis of liver fibrosis in patients with chronic liver disease and hepatitis C virus (HCV) compared with the serum liver fibrosis biomarkers using the results of liver biopsy as the reference standard.

METHODS

We analyzed 233 consecutive HCV patients. On the same day, 2D SWE m, biochemical tests, and liver biopsy were performed. We used the METAVIR staging system and receiver operating characteristic curves for the analysis.

RESULTS

The success rate of 2D-SWE was 98.7%. The median shear wave velocities (SWVs) of patients in the F0, F1, F2, F3, and F4 stages were 1.35 m/s, 1.42 m/s, 1.58 m/s, 1.83 m/s, and 2.13 m/s, respectively, demonstrating a stepwise increase (P < .0001). The accuracy of 2D-SWE in the prediction of ≥F1, ≥F2, ≥F3, and F4 was .888 (95% CI: .85-.93), .915 (95% CI: .88-095), .940 (95% CI: .91-.97), and .949 (95% CI: .92-.97), respectively. 2D-SWE was significantly superior to serum liver fibrosis biomarkers.

CONCLUSION

2D-SWE was positively correlated with the severity of liver fibrosis and was more useful for to predict all liver fibrosis grades in HCV patients than liver fibrosis biomarkers.

摘要

目的

本前瞻性研究旨在评估二维剪切波弹性成像(2D SWE)在慢性肝病和丙型肝炎病毒(HCV)患者肝纤维化诊断中的诊断准确性,并与血清肝纤维化生物标志物进行比较,以肝活检结果作为参考标准。

方法

我们分析了233例连续的HCV患者。在同一天进行了2D SWE检查、生化检测和肝活检。我们使用METAVIR分期系统和受试者操作特征曲线进行分析。

结果

2D-SWE的成功率为98.7%。F0、F1、F2、F3和F4期患者的中位剪切波速度(SWV)分别为1.35 m/s、1.42 m/s、1.58 m/s、1.83 m/s和2.13 m/s,呈逐步升高趋势(P <.0001)。2D-SWE预测≥F1、≥F2、≥F3和F4的准确率分别为.888(95%CI:.85-.93)、.915(95%CI:.88-095)、.940(95%CI:.91-.97)和.949(95%CI:.92-.97)。2D-SWE明显优于血清肝纤维化生物标志物。

结论

2D-SWE与肝纤维化严重程度呈正相关,在预测HCV患者所有肝纤维化分级方面比肝纤维化生物标志物更有用。

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