Department of Gastroenterology, Victor Babes University of Medicine and Pharmacy Timişoara, Romania.
Ultrasound Q. 2020 Nov 2;37(2):97-104. doi: 10.1097/RUQ.0000000000000527.
The aim was to evaluate the performance of 2-dimensional (2D) shear-wave elastography from general electric (2D SWE-GE), implemented on the new LOGIQ S8 system, for the noninvasive assessment of liver fibrosis, and to identify liver stiffness (LS) cutoff values for predicting different stages of fibrosis using transient elastography (TE) as the control method. We included 179 consecutive subjects, with or without chronic hepatopathies, in whom LS was evaluated in the same session using 2 elastographic techniques: TE (FibroScan, EchoSens) and 2D SWE-GE (LOGIQ S8; GE Healthcare, Chalfont St Giles, United Kingdom). Reliable LS measurements were defined for TE: the median value of 10 measurements with a success rate of 60% or greater and an interquartile range/median ratio (IQR/M) < 0.30; for 2D SWE-GE: the median value of 10 measurements acquired in a homogenous area and IQR/M < 0.30. To discriminate between fibrosis stages by TE, we used the following cutoffs: F2-7; F3-9.5 and F4-12 kPa. Reliable LS measurements were obtained in 97.2% subjects by 2D SWE-GE and in 98.3% by TE (P = 0.72), so that 171 subjects were included for the final analysis. A good correlation was found between the LS values obtained by the 2 methods (r = 0.72, P < 0.0001). The best 2D SWE-GE cutoff value for F ≥ 2 was 6.9 kPa (areas under receiver operating characteristic [AUROC], 0.93; sensitivity, 85.8%; specificity, 90.2%), for F of 3 or greater, it was 8.2 kPa (AUROC, 0.93; sensitivity, 87.5%; specificity, 86.8%) and for F value of 4, it was 9.3 kPa (AUROC, 0.91; sensitivity, 85.7%; specificity, 81.2%). In conclusion, the best 2D SWE-GE (S8) cutoff values for predicting F2, F ≥ 3 and F = 4 were 6.9, 8.2, and 9.3 kPa.
目的是评估通用电气(2D SWE-GE)的二维(2D)剪切波弹性成像技术在新 LOGIQ S8 系统上用于非侵入性评估肝纤维化的性能,并确定肝硬度(LS)截断值,以使用瞬态弹性成像(TE)作为对照方法预测不同阶段的纤维化。我们纳入了 179 例连续患有或不患有慢性肝病的患者,在同一次检查中使用两种弹性成像技术评估 LS:TE(FibroScan,EchoSens)和 2D SWE-GE(LOGIQ S8;GE Healthcare,英国钱利圣吉尔斯)。对于 TE,定义了可靠的 LS 测量值:10 次测量的中位数,成功率为 60%或更高,四分位距/中位数比(IQR/M)<0.30;对于 2D SWE-GE:在同质区域中获得的 10 次测量的中位数,IQR/M<0.30。为了通过 TE 区分纤维化阶段,我们使用以下截断值:F2-7;F3-9.5 和 F4-12 kPa。通过 2D SWE-GE 获得了 97.2%的受试者的可靠 LS 测量值,通过 TE 获得了 98.3%的可靠 LS 测量值(P=0.72),因此最终分析纳入了 171 例受试者。这两种方法获得的 LS 值之间存在良好的相关性(r=0.72,P<0.0001)。对于 F≥2,最佳的 2D SWE-GE 截断值为 6.9 kPa(接受者操作特征曲线下面积[AUROC],0.93;敏感性,85.8%;特异性,90.2%),对于 F≥3,最佳截断值为 8.2 kPa(AUROC,0.93;敏感性,87.5%;特异性,86.8%),对于 F=4,最佳截断值为 9.3 kPa(AUROC,0.91;敏感性,85.7%;特异性,81.2%)。总之,预测 F2、F≥3 和 F=4 的最佳 2D SWE-GE(S8)截断值分别为 6.9、8.2 和 9.3 kPa。