Gharibvand Mohammad M, Asare Mohammad, Motamedfar Azim, Alavinejad Pezhman, Momeni Mohammad
Department of Radiology, Golestan Hospital, Ahvaz Jundishapur University of Medicine, Ahvaz, Iran.
Department of Internal Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
J Family Med Prim Care. 2020 Feb 28;9(2):943-949. doi: 10.4103/jfmpc.jfmpc_828_19. eCollection 2020 Feb.
Liver biopsy is considered as the gold standard for diagnosis of chronic liver disease, yet liver biopsy is an invasive method that may be associated with complications. Therefore, non-invasive methods are needed to diagnose fibrosis. This study was conducted to compare liver stiffness measured by Shear-wave Elastography (SWE) to fibrosis in liver biopsy.
In this prospective study, 176 adult patients with chronic liver disease of different etiologies were included. All patients were evaluated using SWE and a liver biopsy. The diagnostic accuracy of SWE was evaluated using receiver operating characteristics (ROC) plots based on the degree of fibrosis (METAVIR score). SPSS software version 19 was used for statistical analysis and < 0.05 considered significant.
There was a significant correlation between liver stiffness and fibrosis stage (ρ=0.939; < 0.0001). The ROC curve AUC were 0.871, 0.895 and 0.937 for fibrosis stages F2, F3 and F4 respectively. The cutoff values were 8.6 kPa for F2, 10.7 kPa for F3, and 13.8 kPa for F4, with sensitivity and specificity of 81.76% and 77.01%, 90.20% and 78.40%, 89.53% and 94.38% respectively.
The results of this study showed that liver SWE is an effective non-invasive method for assessing liver fibrosis in patients with chronic liver disease of different etiologies.
肝活检被认为是诊断慢性肝病的金标准,但肝活检是一种侵入性方法,可能会引发并发症。因此,需要采用非侵入性方法来诊断肝纤维化。本研究旨在比较通过剪切波弹性成像(SWE)测量的肝脏硬度与肝活检中的肝纤维化情况。
在这项前瞻性研究中,纳入了176例不同病因的慢性肝病成年患者。所有患者均接受了SWE检查和肝活检。基于纤维化程度(METAVIR评分),使用受试者工作特征(ROC)曲线评估SWE的诊断准确性。采用SPSS 19软件进行统计分析,P<0.05被视为具有统计学意义。
肝脏硬度与纤维化分期之间存在显著相关性(ρ=0.939;P<0.0001)。纤维化分期F2、F3和F4的ROC曲线下面积(AUC)分别为0.871、0.895和0.937。F2的截断值为8.6 kPa,F3为10.7 kPa,F4为13.8 kPa,敏感性和特异性分别为81.76%和77.01%、90.20%和78.40%、89.53%和94.38%。
本研究结果表明,肝脏SWE是评估不同病因慢性肝病患者肝纤维化的一种有效的非侵入性方法。