Organ Transplant Center, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China; Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Organ Transplant Center, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China; Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Ultrasound Med Biol. 2021 Mar;47(3):408-427. doi: 10.1016/j.ultrasmedbio.2020.11.013. Epub 2020 Dec 17.
Progressive liver fibrosis may result in cirrhosis, portal hypertension and increased risk of hepatocellular carcinoma. We performed a meta-analysis to compare liver fibrosis staging in chronic liver disease patients using 2-D shear wave elastography (2-D SWE) and point shear wave elastography (pSWE). The PubMed, Web of Science and Cochrane Library databases were searched until May 31, 2020 for studies evaluating the diagnostic performance of 2-D SWE and pSWE in assessing liver fibrosis. Pooled sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratios and area under receiver operating characteristic curve were estimated using the bivariate random effects model. As a result, 71 studies with 11,345 patients were included in the analysis. The pooled sensitivities of 2-D SWE and pSWE significantly differed for the detection of significant fibrosis (F ≥ 2; 0.84 vs. 0.76, p < 0.001) and advanced fibrosis (F ≥ 3; 0.90 vs. 0.83, p = 0.003), but not for detection of cirrhosis (F = 4; 0.89 vs. 0.85, p = 0.090). The pooled specificities of 2-D SWE and pSWE did not significantly differ for detection of F ≥ 2 (0.81 vs. 0.79, p = 0.753), F ≥ 3 (0.87 vs. 0.83, p = 0.163) or F = 4 (0.87 vs. 0.84, p = 0.294). Both 2-D SWE and pSWE have high sensitivity and specificity for detecting each stage of liver fibrosis. Two-dimensional SWE has higher sensitivity than pSWE for detection of significant fibrosis and advanced fibrosis.
进行性肝纤维化可导致肝硬化、门静脉高压和肝细胞癌风险增加。我们进行了一项荟萃分析,比较了二维剪切波弹性成像(2-D SWE)和单点剪切波弹性成像(pSWE)在慢性肝病患者中肝纤维化分期的诊断价值。检索PubMed、Web of Science 和 Cochrane Library 数据库,评估 2-D SWE 和 pSWE 评估肝纤维化的诊断性能的研究,截至 2020 年 5 月 31 日。使用双变量随机效应模型估计汇总敏感性、特异性、阳性和阴性似然比、诊断优势比和受试者工作特征曲线下面积。结果,纳入了 71 项研究,共 11345 例患者。2-D SWE 和 pSWE 检测显著纤维化(F≥2;0.84 与 0.76,p<0.001)和进展性纤维化(F≥3;0.90 与 0.83,p=0.003)的汇总敏感性有显著差异,但肝硬化(F=4;0.89 与 0.85,p=0.090)的检测结果没有显著差异。2-D SWE 和 pSWE 检测 F≥2(0.81 与 0.79,p=0.753)、F≥3(0.87 与 0.83,p=0.163)或 F=4(0.87 与 0.84,p=0.294)的特异性无显著差异。二维 SWE 和 pSWE 对检测每个阶段的肝纤维化均具有较高的敏感性和特异性。二维 SWE 在检测显著纤维化和进展性纤维化方面的敏感性高于 pSWE。