Department of Gastroenterology, Changhua Christian Hospital, Changhua, Taiwan.
J Ultrasound Med. 2021 Sep;40(9):1919-1926. doi: 10.1002/jum.15576. Epub 2020 Dec 7.
Successful antiviral treatment in patients with hepatitis C can lead to reduced liver stiffness. In this study, we attempted to compare 2-dimensional (2D) shear wave elastography (SWE), shear wave dispersion (SWD), and attenuation imaging (ATI) with transient elastography (TE) and the controlled attenuation parameter (CAP) in patients under direct-acting antiviral (DAA) therapy.
Patients with chronic hepatitis C infection undergoing DAA therapy from January 2017 to June 2020 were retrospectively examined. The results of 2D SWE, SWD, ATI, TE, and CAP were recorded before and 12 weeks after the completion of DAA therapy.
A total of 122 patients with a median age of 61 years were investigated; among them, 121 (99.2%) achieved a sustained virologic response at 12 weeks after DAA therapy. Fibrosis 4, the aspartate aminotransferase-to-platelet ratio index, 2D SWE, and TE were reduced after DAA therapy. The CAP was increased; however, SWD and ATI showed no statistically significant changes after DAA therapy. Two-dimensional SWE and TE were strongly correlated (r = 0.885-0.897; P < .001). Albumin and the baseline liver stiffness measurement were independent factors of liver stiffness measurement changes after DAA therapy.
Direct-acting antiviral therapy can significantly decrease liver stiffness (using both 2D SWE and TE) but not SWD and ATI values in patients with hepatitis C. An increased CAP is also observed after DAA therapy.
慢性丙型肝炎患者接受抗病毒治疗后，如果病毒得到成功抑制，其肝硬度值会相应降低。本研究旨在比较二维剪切波弹性成像（2D-SWE）、剪切波分散度（SWD）、衰减成像（ATI）与瞬时弹性成像（TE）和受控衰减参数（CAP）在直接作用抗病毒（DAA）治疗患者中的差异。
回顾性分析 2017 年 1 月至 2020 年 6 月接受 DAA 治疗的慢性丙型肝炎感染患者。记录患者 DAA 治疗前和治疗结束后 12 周的 2D-SWE、SWD、ATI、TE 和 CAP 结果。
共纳入 122 例中位年龄为 61 岁的患者，其中 121 例（99.2%）在 DAA 治疗结束后 12 周时达到持续病毒学应答。纤维化 4 评分、天冬氨酸转氨酶-血小板比值指数、2D-SWE 和 TE 在 DAA 治疗后降低，而 CAP 增加，但 SWD 和 ATI 在 DAA 治疗后无明显变化。2D-SWE 和 TE 呈强相关（r=0.885-0.897；P<0.001）。白蛋白和基线肝硬度值是 DAA 治疗后肝硬度值变化的独立因素。
DAA 治疗可显著降低丙型肝炎患者的肝硬度（2D-SWE 和 TE），但不会降低 SWD 和 ATI 值。DAA 治疗后 CAP 也会增加。
