Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
WHO Collaborating Center for Pharmaceutical Policy and Regulation, Department of Pharmaceutical Science, Utrecht University, Utrecht, Netherlands.
Korean J Radiol. 2019 Jun;20(6):880-893. doi: 10.3348/kjr.2018.0812.
To assess the technical performance of two-dimensional shear wave elastography (2D-SWE) for measuring liver stiffness.
The Ovid-MEDLINE and EMBASE databases were searched for studies reporting the technical performance of 2D-SWE, including concerns with technical failures, unreliable measurements, interobserver reliability, and/or intraobserver reliability, published until June 30, 2018. The pooled proportion of technical failure and unreliable measurements was calculated using meta-analytic pooling via the random-effects model and inverse variance method for calculating weights. Subgroup analyses were performed to explore potential causes of heterogeneity. The pooled intraclass correlation coefficients (ICCs) for interobserver and intraobserver reliability were calculated using the Hedges-Olkin method with Fisher's Z transformation of the correlation coefficient.
The search yielded 34 articles. From 20 2D-SWE studies including 6196 patients, the pooled proportion of technical failure was 2.3% (95% confidence interval [CI], 1.3-3.9%). The pooled proportion of unreliable measurements from 20 studies including 6961 patients was 7.5% (95% CI, 4.7-11.7%). In the subgroup analyses, studies conducting more than three measurements showed fewer unreliable measurements than did those with three measurements or less, but no intergroup difference was found in technical failure. The pooled ICCs for interobserver reliability (from 10 studies including 517 patients) and intraobserver reliability (from 7 studies including 679 patients) were 0.87 (95% CI, 0.82-0.90) and 0.93 (95% CI, 0.89-0.95), respectively, suggesting good to excellent reliability.
2D-SWE shows good technical performance for assessing liver stiffness, with high technical success and reliability. Future studies should establish the quality criteria and optimal number of measurements.
评估二维剪切波弹性成像（2D-SWE）测量肝脏硬度的技术性能。
检索 Ovid-MEDLINE 和 EMBASE 数据库，检索截至 2018 年 6 月 30 日发表的关于 2D-SWE 技术性能的研究，包括技术失败、不可靠测量、观察者间可靠性和/或观察者内可靠性等方面的问题。采用随机效应模型和逆方差法进行荟萃分析，计算技术失败和不可靠测量的合并比例。进行亚组分析以探索异质性的潜在原因。采用 Hedges-Olkin 法和相关系数 Fisher's Z 变换计算观察者间和观察者内可靠性的合并组内相关系数（ICC）。
搜索结果得到 34 篇文章。在纳入的 20 项 2D-SWE 研究中，共有 6196 例患者，技术失败的合并比例为 2.3%（95%可信区间[CI]，1.3-3.9%）。在纳入的 20 项研究中，共有 6961 例患者，不可靠测量的合并比例为 7.5%（95% CI，4.7-11.7%）。在亚组分析中，进行 3 次以上测量的研究较进行 3 次或更少测量的研究显示出更少的不可靠测量，但在技术失败方面未发现组间差异。10 项研究（包括 517 例患者）中观察者间可靠性的合并 ICC 为 0.87（95% CI，0.82-0.90），7 项研究（包括 679 例患者）中观察者内可靠性的合并 ICC 为 0.93（95% CI，0.89-0.95），提示具有良好到极好的可靠性。
2D-SWE 具有良好的技术性能，可用于评估肝脏硬度，具有较高的技术成功率和可靠性。未来的研究应建立质量标准和最佳测量次数。
Zotero 插件
