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酒精性肝病患者肝脏和胰腺硬度的可行性和可重复性。

Feasibility and reproducibility of liver and pancreatic stiffness in patients with alcohol-related liver disease.

机构信息

Department of Pathophysiology and Organ Transplantation, Maggiore Hospital and IRRCS Foundation, University of Milan, Milan, Italy.

Department of Internal Medicine 1, Hospital of the Goethe University, Frankfurt, Germany.

出版信息

Dig Liver Dis. 2019 Jul;51(7):1023-1029. doi: 10.1016/j.dld.2018.12.017. Epub 2019 Jan 3.

Abstract

BACKGROUND

To date no studies evaluated liver stiffness and pancreatic stiffness by shear-wave elastography, in alcoholic liver disease setting.

AIMS

To assess feasibility and reproducibility of Shear-wave elastrography in measuring liver and pancreatic stiffness in alcoholic liver disease and investigate the correlation among liver and pancreatic stiffness and clinical data.

METHODS

Liver and pancreatic stiffness were measured by elastography (2 examiners) in patients with alcoholic liver disease and in healthy volunteers, for reference values. Effect of clinical data was evaluated on log-transformed pancreatic or liver stiffness, using univariate and multivariate linear regression model.

RESULTS

87 patients and 46 healthy volunteers enrolled. Both the stiffness values were higher in patients than healthy volunteers (p < 0.001). For liver stiffness: no failure measurements found, the Intraclass correlation coefficient (between 2 examiners) was 0.72 and the variables significantly correlated at multivariate analysis were cirrhosis (p < 0.0001) and steatosis (p = .007). For pancreatic stiffness: 2 failures found, with ICC 0.40 and the only variable significantly correlated at multivariate analysis was liver cirrhosis (p = .005).

CONCLUSIONS

Shear-wave elastography feasibility was good for liver and pancreatic stiffness. Reproducibility was good for liver stiffness, whereas fair for pancreatic one. Both the stiffness correlated with alcoholic liver disease severity. Elastography could be a useful tool to detect and monitor alcohol-related liver and pancreatic damage.

摘要

背景

迄今为止,尚无研究评估剪切波弹性成像在酒精性肝病中的肝硬度和胰腺硬度。

目的

评估剪切波弹性成像测量酒精性肝病患者肝和胰腺硬度的可行性和可重复性,并探讨肝和胰腺硬度与临床数据之间的相关性。

方法

对酒精性肝病患者和健康志愿者进行弹性成像检查(2 名检查者),以获得肝和胰腺的参考值。使用单变量和多变量线性回归模型评估临床数据对胰腺或肝硬度的对数转换值的影响。

结果

共纳入 87 例患者和 46 名健康志愿者。患者的硬度值均高于健康志愿者(p<0.001)。对于肝硬度:未发现失败测量值,两名检查者之间的组内相关系数(ICC)为 0.72,多变量分析中显著相关的变量为肝硬化(p<0.0001)和脂肪变性(p=0.007)。对于胰腺硬度:发现 2 次失败,ICC 为 0.40,多变量分析中唯一显著相关的变量是肝硬化(p=0.005)。

结论

剪切波弹性成像测量肝和胰腺硬度的可行性良好。肝硬度的重复性良好,而胰腺硬度的重复性一般。两者的硬度均与酒精性肝病的严重程度相关。弹性成像可能是一种有用的工具,可用于检测和监测与酒精相关的肝和胰腺损伤。

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