Lin Y, Ding H, Zhuang Y, Zhang Y, Zhu Y L, Wang W P
Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Zhonghua Yi Xue Za Zhi. 2018 Apr 17;98(15):1148-1151. doi: 10.3760/cma.j.issn.0376-2491.2018.15.005.
To evaluate the diagnostic value of two-dimensional shear wave elastography(2D-SWE)in the assessment of hepatic fibrosis in a large-scale clinical setting. A total of 1 079 subjects who underwent partial hepatectomy were examined with 2D-SWE to measure liver stiffness before operation and the liver stiffness measurements were compared with histologic findings.The published cutoff values of liver stiffness examined with 2D-SWE were used as a reference, as 7.2, 9.2, and 10.4 kPa for diagnosing substantial fibrosis(S2), severe fibrosis(S3), and cirrhosis(S4), respectively.The area under curve(AUC)was calculated to verify the value of 2D-SWE in the evaluation of hepatic fibrosis. Compared with the pathological diagnosis, the AUC of 2D-SWE in diagnosing substantial fibrosis(S2), severe fibrosis(S3), and cirrhosis(S4)were 0.976, 0.981, and 0.968, the sensitivity were 95.3%, 92.6%, and 93.5%, the specificity were 87.8%, 87.5% and 89.3%, and the accuracy were 88.8%, 90.0% and 91.0%, respectively(<0.05). 2D-SWE is an effective imaging tool for noninvasive diagnosis of hepatic fibrosis.
为评估二维剪切波弹性成像（2D-SWE）在大规模临床环境中对肝纤维化评估的诊断价值。共有1079例行肝部分切除术的受试者接受了2D-SWE检查，以测量术前肝脏硬度，并将肝脏硬度测量值与组织学结果进行比较。以已发表的2D-SWE检查肝脏硬度的截断值作为参考，诊断显著纤维化（S2）、严重纤维化（S3）和肝硬化（S4）的截断值分别为7.2、9.2和10.4 kPa。计算曲线下面积（AUC）以验证2D-SWE在评估肝纤维化中的价值。与病理诊断相比，2D-SWE诊断显著纤维化（S2）、严重纤维化（S3）和肝硬化（S4）的AUC分别为0.976、0.981和0.968，敏感性分别为95.3%、92.6%和93.5%，特异性分别为87.8%、87.5%和89.3%，准确性分别为88.8%、90.0%和91.0%（P<0.05）。2D-SWE是一种用于肝纤维化无创诊断的有效成像工具。
