Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
J Gastroenterol Hepatol. 2020 Jan;35(1):135-141. doi: 10.1111/jgh.14782. Epub 2019 Jul 29.
Transient elastography (TE) and point shear wave elastography (pSWE) are noninvasive methods to diagnose fibrosis stage in patients with chronic liver disease. The aim of this study is to compare the accuracy of the two methods to diagnose fibrosis stage in non-alcoholic fatty liver disease (NAFLD) and to study the intra-observer and inter-observer variability when the examinations were performed by healthcare personnel of different backgrounds.
Consecutive NAFLD patients who underwent liver biopsy were enrolled in this study and had two sets each of pSWE and TE examinations by a nurse and a doctor on the same day of liver biopsy procedure. The medians of the four sets of pSWE and TE were used for evaluation of diagnostic accuracy using area under receiver operating characteristic curve (AUROC). Intra-observer and inter-observer variability was analyzed using intraclass correlation coefficients.
Data for 100 NAFLD patients (mean age 57.1 ± 10.2 years; male 46.0%) were analyzed. The AUROC of TE for diagnosis of fibrosis stage ≥ F1, ≥ F2, ≥ F3, and F4 was 0.89, 0.83, 0.83, and 0.89, respectively. The corresponding AUROC of pSWE was 0.80, 0.72, 0.69, and 0.79, respectively. TE was significantly better than pSWE for the diagnosis of fibrosis stages ≥ F2 and ≥ F3. The intra-observer and inter-observer variability of TE and pSWE measurements by the nurse and doctor was excellent with intraclass correlation coefficient > 0.96.
Transient elastography was significantly better than pSWE for the diagnosis of fibrosis stage ≥ F2 and ≥ F3. Both TE and pSWE had excellent intra-observer and inter-observer variability when performed by healthcare personnel of different backgrounds.
瞬时弹性成像（TE）和点剪切波弹性成像（pSWE）是诊断慢性肝病患者纤维化分期的非侵入性方法。本研究旨在比较两种方法诊断非酒精性脂肪性肝病（NAFLD）纤维化分期的准确性，并研究不同背景医护人员进行检查时的观察者内和观察者间变异性。
本研究纳入了连续接受肝活检的 NAFLD 患者，在肝活检当天由护士和医生分别对每位患者进行两次 pSWE 和 TE 检查。使用四个 pSWE 和 TE 检查的中位数评估诊断准确性，使用接受者操作特征曲线下面积（AUROC）。使用组内相关系数分析观察者内和观察者间变异性。
共分析了 100 例 NAFLD 患者的数据（平均年龄 57.1±10.2 岁；男性 46.0%）。TE 诊断纤维化分期≥F1、≥F2、≥F3 和 F4 的 AUROC 分别为 0.89、0.83、0.83 和 0.89。相应的 pSWE 的 AUROC 分别为 0.80、0.72、0.69 和 0.79。TE 在诊断纤维化分期≥F2 和≥F3 方面明显优于 pSWE。护士和医生进行的 TE 和 pSWE 测量的观察者内和观察者间变异性均极好，组内相关系数>0.96。
TE 在诊断纤维化分期≥F2 和≥F3 方面明显优于 pSWE。不同背景医护人员进行检查时，TE 和 pSWE 的观察者内和观察者间变异性均极好。
