Iijima Hiroko, Tada Toshifumi, Kumada Takashi, Kobayashi Natsuko, Yoshida Masahiro, Aoki Tomoko, Nishimura Takashi, Nakano Chikage, Ishii Akio, Takashima Tomoyuki, Sakai Yoshiyuki, Aizawa Nobuhiro, Nishikawa Hiroki, Ikeda Naoto, Iwata Yoshinori, Enomoto Hirayuki, Ide Yoshi-Hiro, Hirota Seiichi, Fujimoto Jiro, Nishiguchi Shuhei
Ultrasound Imaging Center, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
Hepatol Res. 2019 Jun;49(6):676-686. doi: 10.1111/hepr.13319. Epub 2019 Mar 5.
Transient elastography (TE) is the gold standard for measurement of liver stiffness. The usefulness of shear wave elastographies (SWE) is well accepted. However, the measurement values cannot be equivalently compared because cut-off values for the diagnosis of liver fibrosis are different among those devices. We aimed to clarify correlations, to generate the regression equations between TE and SWEs, and to compare the diagnostic ability of each device to diagnose liver fibrosis.
A total of 109 patients with chronic liver disease who underwent liver biopsy and same-day evaluation of liver stiffness using six ultrasound devices were analyzed. The diagnostic ability of liver stiffness from each ultrasound device and correlations between TE and each SWE were analyzed.
Liver stiffness measured by all six ultrasound devices increased significantly as liver fibrosis stage advanced (P < 0.001). Receiver operating characteristic (ROC) curve analysis for predicting significant fibrosis (≥F2) and cirrhosis yielded area under the ROC curve (AUROC) values based on TE of 0.830 (95% confidence interval [CI], 0.755-0.905) and 0.959 (95% CI, 0.924-0.995), respectively. The AUROCs for predicting significant fibrosis (≥F2) and cirrhosis (F4) based on SWE from all five ultrasound devices were over 0.8 and 0.9, respectively. Furthermore, the correlation coefficients between TE values and SWE values from five ultrasound devices were all over 0.8, indicating a strong relationship.
Our study showed strong correlations between TE and SWEs with high correlation coefficients. The regression equations between TE and SWEs demonstrated the ability to compare the measurement values in each device equivalently.
瞬时弹性成像（TE）是测量肝脏硬度的金标准。剪切波弹性成像（SWE）的实用性已得到广泛认可。然而，由于这些设备诊断肝纤维化的临界值不同，测量值无法进行等效比较。我们旨在阐明相关性，生成TE与SWE之间的回归方程，并比较各设备诊断肝纤维化的能力。
对109例慢性肝病患者进行分析，这些患者接受了肝活检，并使用六种超声设备在同一天评估肝脏硬度。分析了每种超声设备测量肝脏硬度的诊断能力以及TE与每种SWE之间的相关性。
随着肝纤维化阶段的进展，所有六种超声设备测量的肝脏硬度均显著增加（P < 0.001）。预测显著纤维化（≥F2）和肝硬化的受试者操作特征（ROC）曲线分析得出，基于TE的ROC曲线下面积（AUROC）值分别为0.830（95%置信区间[CI]，0.755 - 0.905）和0.959（95%CI，0.924 - 0.995）。基于所有五种超声设备的SWE预测显著纤维化（≥F2）和肝硬化（F4）的AUROC分别超过0.8和0.9。此外，五种超声设备的TE值与SWE值之间的相关系数均超过0.8，表明两者关系密切。
我们的研究表明TE与SWE之间具有很强的相关性，相关系数很高。TE与SWE之间的回归方程证明了能够等效比较各设备的测量值。
