Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, China.
West China School of Medicine, Sichuan University, Chengdu, China.
Ultraschall Med. 2020 Feb;41(1):60-68. doi: 10.1055/a-0731-0178. Epub 2019 Jan 7.
Transient elastography-based liver stiffness value (TE-LSV) has been studied for the diagnosis of portal hypertension. Liver stiffness is influenced by the disease etiology. We aimed to perform a meta-analysis to determine the performance of TE-LSV for diagnosing portal hypertension in patients with alcoholic liver disease (ALD).
We searched PubMed, Web of Science, Ovid and Cochrane library. A bivariate model was used to compute sensitivity and specificity. A random effects model was used to pool diagnostic odds ratios.
9 studies with 679 patients were included. The pooled sensitivity and specificity based on a cut-off value around 21.8 kPa for clinically significant portal hypertension (CSPH) were 0.89 (95 % confidence interval (CI), 0.83-0.93) and 0.71(95 % CI, 0.64-0.78), respectively. For severe portal hypertension (SPH), the pooled sensitivity and specificity for a cut-off value around 29.1 kPa were 0.88 (95 % CI, 0.83-0.92) and 0.74 (95 % CI, 0.67-0.81), respectively.
TE-LSV showed good performance for diagnosing portal hypertension in patients with ALD. The optimal cut-off value for CSPH and SPH was around 21.8 kPa and 29.1 kPa, respectively, and these two cut-off values showed good sensitivity and modest specificity. The etiology should be clear before using TE-LSV for portal hypertension.
基于瞬时弹性成像的肝硬度值（TE-LSV）已被用于门静脉高压症的诊断。肝脏硬度受疾病病因的影响。我们旨在进行一项荟萃分析，以确定 TE-LSV 在诊断酒精性肝病（ALD）患者门静脉高压症中的性能。
我们检索了 PubMed、Web of Science、Ovid 和 Cochrane 图书馆。使用双变量模型计算敏感性和特异性。使用随机效应模型计算诊断比值比。
纳入了 9 项研究，共 679 名患者。基于约 21.8 kPa 的临界值，用于诊断临床显著门静脉高压症（CSPH）的汇总敏感性和特异性分别为 0.89（95%置信区间[CI]，0.83-0.93）和 0.71（95% CI，0.64-0.78）。对于严重门静脉高压症（SPH），基于约 29.1 kPa 的临界值，汇总敏感性和特异性分别为 0.88（95% CI，0.83-0.92）和 0.74（95% CI，0.67-0.81）。
TE-LSV 对诊断 ALD 患者的门静脉高压症具有良好的性能。CSPH 和 SPH 的最佳临界值分别约为 21.8 kPa 和 29.1 kPa，这两个临界值具有良好的敏感性和适度的特异性。在使用 TE-LSV 诊断门静脉高压症之前，应明确病因。
