Ryu Hwaseong, Ahn Su Joa, Yoon Jeong Hee, Lee Jeong Min
Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea.
Department of Radiology, Gachon University Gil Medical Center, Incheon, Korea.
Ultrasonography. 2019 Jul;38(3):246-254. doi: 10.14366/usg.18046. Epub 2018 Nov 23.
The purpose of this study was to retrospectively compare the technical success and reliability of the measurements made using two 2-dimensional (2D) shear wave elastography (SWE) systems using the comb-push technique from the same manufacturer and to assess the intersystem reproducibility of the resultant liver stiffness (LS) measurements.
Ninety-four patients with suspected chronic liver diseases were included in this retrospective study. LS measurements were obtained using two 2D-SWE systems (LOGIQ E9 and LOGIQ S8) from the same manufacturer, with transient elastography (TE) serving as the reference standard, on the same day. The technical success rates and reliability of the measurements of the two 2D-SWE systems were compared. LS values measured using the two 2D-SWE systems and TE were correlated using Spearman correlation coefficients and 95% Bland-Altman limits of agreement. Thereafter, Bland-Altman limits of agreement and intraclass correlation coefficients (ICCs) were used to analyze the intersystem reproducibility of LS measurements.
The two 2D-SWE systems showed similar technical success rates (98.9% for both) and reliability of LS measurements (92.3% for the LOGIQ E9, 91.2% for the LOGIQ S8; P=0.185). Despite the excellent correlation (ICC=0.92), the mean LS measurements obtained by the two 2D-SWE systems were significantly different (LOGIQ E9, 6.57±2.33 kPa; LOGIQ S8, 6.90±6.64 kPa; P=0.018).
Significant intersystem variability was observed in the LS measurements made using the two 2D-SWE systems. Therefore, even 2D-SWE systems from the same manufacturer should not be used interchangeably in longitudinal follow-up.
本研究旨在回顾性比较使用同一制造商的两种二维（2D）剪切波弹性成像（SWE）系统采用梳推技术进行测量的技术成功率和可靠性，并评估所得到的肝脏硬度（LS）测量值的系统间可重复性。
本回顾性研究纳入了94例疑似慢性肝病患者。同一天，使用同一制造商的两种2D-SWE系统（LOGIQ E9和LOGIQ S8）进行LS测量，并以瞬时弹性成像（TE）作为参考标准。比较两种2D-SWE系统测量的技术成功率和可靠性。使用Spearman相关系数以及95%布兰德-奥特曼一致性界限，对两种2D-SWE系统测量的LS值与TE测量的LS值进行相关性分析。此后，使用布兰德-奥特曼一致性界限和组内相关系数（ICC）分析LS测量的系统间可重复性。
两种2D-SWE系统显示出相似的技术成功率（均为98.9%）以及LS测量的可靠性（LOGIQ E9为92.3%，LOGIQ S8为91.2%；P = 0.185）。尽管相关性良好（ICC = 0.92），但两种2D-SWE系统获得的平均LS测量值存在显著差异（LOGIQ E9，6.57±2.33 kPa；LOGIQ S8，6.90±6.64 kPa；P = 0.018）。
使用两种2D-SWE系统进行LS测量时观察到显著的系统间变异性。因此，即使是同一制造商的2D-SWE系统，在纵向随访中也不应互换使用。
