二维剪切波弹性成像评估肝脏硬度等非侵入性方法预测食管静脉曲张的价值。

Usefulness of noninvasive methods including assessment of liver stiffness by 2-dimensional shear wave elastography for predicting esophageal varices.

机构信息

Division of Gastroenterology and Hepatology, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea.

出版信息

Dig Liver Dis. 2019 Dec;51(12):1706-1712. doi: 10.1016/j.dld.2019.06.007. Epub 2019 Jul 4.

DOI:10.1016/j.dld.2019.06.007

PMID:31281068

Abstract

BACKGROUND

The aim of this study was to predict the presence of esophageal varices (EVs) by noninvasive tools combined with 2-dimensional shear wave elastography (2D-SWE), and to compare the diagnostic capabilities of 2D-SWE with those of transient elastography (TE).

METHODS

Between January 2015 and December 2017, 289 patients with compensated advanced chronic liver disease (cACLD) who underwent consecutive 2D-SWE and EGD were enrolled. Capabilities for predicting the presence of EVs of 2D-SWE and models combining 2D-SWE with other noninvasive tools (modified LS-spleen-diameter-to-platelet-ratio score [mLSPS], platelet-spleen ratio score) were compared. A subgroup analysis was performed on 177 patients who also underwent simultaneous TE.

RESULTS

The area under receiver operating characteristics (AUROCs) for detecting EVs for 2D-SWE alone vs. mLSPS, which included 2D-SWE, were 0.757 (95% confidence interval [CI], 0.701-0.810) and 0.813 (95% CI, 0.763-.857), respectively. The AUROCs for predicting varices needing treatment (VNT) for 2D-SWE and mLSPS were 0.712 (95% CI, 0.621-0.738) and 0.834 (95% CI, 0.785-0.875), respectively. For the 195 patients who underwent simultaneous TE and 2D-SWE, no differences in diagnostic performance were observed.

CONCLUSIONS

The diagnostic performance of 2D-SWE is similar to that of TE for predicting the presence of EVs. The mLSPS, which includes 2D-SWE, seemed to be useful for predicting EVs.

摘要

背景

本研究旨在通过非侵入性工具结合二维剪切波弹性成像（2D-SWE）预测食管静脉曲张（EVs）的存在，并比较 2D-SWE 与瞬时弹性成像（TE）的诊断能力。

方法

2015 年 1 月至 2017 年 12 月，连续接受 2D-SWE 和 EGD 的 289 例代偿性晚期慢性肝病（cACLD）患者入组。比较 2D-SWE 预测 EVs 存在的能力，以及 2D-SWE 与其他非侵入性工具（改良 LS-脾径-血小板比值评分[mLSPSS]、血小板-脾比值评分）相结合的模型。对同时接受 TE 检查的 177 例患者进行亚组分析。

结果

2D-SWE 单独与 mLSPSS（包括 2D-SWE）检测 EVs 的受试者工作特征曲线（AUROC）下面积分别为 0.757（95%置信区间[CI]，0.701-0.810）和 0.813（95%CI，0.763-0.857）。2D-SWE 和 mLSPSS 预测需要治疗的静脉曲张（VNT）的 AUROC 分别为 0.712（95%CI，0.621-0.738）和 0.834（95%CI，0.785-0.875）。在同时接受 TE 和 2D-SWE 检查的 195 例患者中，诊断性能无差异。