空腹和餐后状态下 2 种肝脏二维剪切波弹性成像技术的可重复性。
Reproducibility of 2 Liver 2-Dimensional Shear Wave Elastographic Techniques in the Fasting and Postprandial States.
机构信息
Departments of Medical Imaging, Toronto, Ontario, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
出版信息
J Ultrasound Med. 2019 Jul;38(7):1739-1745. doi: 10.1002/jum.14862. Epub 2018 Dec 11.
OBJECTIVES
The purpose of this study was to compare the reliability and agreement of 2 methods of 2-dimensional (2D) shear wave elastography (SWE) on liver stiffness in healthy volunteers. We also assessed effects of the prandial state and operator experience on measurements.
METHODS
Two operators, 1 experienced and 1 novice, independently examined 20 healthy volunteers with 2D SWE on 2 ultrasound machines (Aixplorer [SuperSonic Imagine, Aix-en-Provence, France] and Aplio 500 [Canon Medical Systems Corporation, Otawara, Japan]). Volunteers were scanned 8 times by the operators using both machines in fasting and postprandial states. Agreement was evaluated by a Bland-Altman analysis, and the correlation was assessed by the Pearson correlation and intraclass correlation coefficients (ICCs). An analysis of variance was conducted to determine the contribution of the machine, prandial state, and operator experience to the variability.
RESULTS
Agreement assessed by Bland-Altman plots showed no statistically significant difference in measured liver stiffness between the machines (mean difference, -0.8%; 95% confidence interval, -3.7%, 2.1%), with a critical difference of 1.36 kPa. The correlation was good to excellent for both the crude overall Pearson coefficient and the ICC, both measuring 0.88 (95% confidence interval, 0.82, 0.92). Subclass ICCs for the fasting state, postprandial state, novice operator, and experienced operator were 0.89, 0.88, 0.90, and 0.86, respectively. The 2-way mixed effect analysis of variance showed that the volunteers accounted for 86.3% of variation in median liver stiffness, with no statistically significant contribution from operator experience, the prandial state, or the machine (P = .108, .067, and .296, respectively).
CONCLUSIONS
Our study showed that the 2D SWE techniques had a high degree of reliability and agreement in measurement of liver stiffness in a healthy population. Operator experience and the prandial state did not impart significant variability to stiffness measurements.
目的
本研究旨在比较两种二维（2D）剪切波弹性成像（SWE）方法在健康志愿者肝硬度测量中的可靠性和一致性。我们还评估了进食状态和操作者经验对测量的影响。
方法
两名操作者（一名经验丰富，一名新手）分别使用两台超声仪（Aixplorer[SuperSonic Imagine，法国艾克斯普罗旺斯]和 Aplio 500[佳能医疗系统公司，日本鸟取]）对 20 名健康志愿者进行 2D SWE 检查。志愿者在空腹和餐后状态下由两名操作者使用两台机器各扫描 8 次。通过 Bland-Altman 分析评估一致性，通过 Pearson 相关系数和组内相关系数（ICC）评估相关性。方差分析用于确定机器、进食状态和操作者经验对变异性的贡献。
结果
通过 Bland-Altman 图评估的一致性显示，两台机器测量的肝硬度无统计学差异（平均差值，-0.8%；95%置信区间，-3.7%，2.1%），临界差异为 1.36kPa。总体 Pearson 系数和 ICC 的粗值均为 0.88（95%置信区间，0.82，0.92），相关性良好至极好。空腹状态、餐后状态、新手操作者和有经验操作者的亚类 ICC 分别为 0.89、0.88、0.90 和 0.86。双因素混合效应方差分析显示，志愿者对中位数肝硬度的变异贡献了 86.3%，操作者经验、进食状态或机器均无统计学显著贡献（P=0.108，0.067 和 0.296）。
结论
本研究表明，2D SWE 技术在健康人群中测量肝硬度具有高度的可靠性和一致性。操作者经验和进食状态对硬度测量无显著影响。
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