Department of Radiology, Seoul National University Hospital, 101 Daehakro, Jongno-gu, Seoul, 03080, South Korea.
Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, South Korea.
Eur Radiol. 2021 Aug;31(8):5802-5811. doi: 10.1007/s00330-020-07662-3. Epub 2021 Jan 18.
Both transient elastography (TE) and 2D shear wave elastography (SWE) are accurate methods to evaluate liver fibrosis. We aimed to evaluate the diagnostic performance of 2D-SWE in predicting post-hepatectomy complication and to compare it with TE.
We prospectively enrolled 125 patients with liver tumors. Liver stiffness (LS) (kilopascal [kPa]) was measured using both TE and 2D-SWE before surgery. All post-operative complication was evaluated using the comprehensive complication index (CCI), and CCI ≥ 26.2 was defined as severe complication. Logistic regression analysis was performed to identify predictive factors for severe complication. Receiver operating characteristic analysis was used to evaluate the diagnostic performance of TE/2D-SWE in detecting liver fibrosis and severe complication.
Severe complication developed in 18 patients. The median LS in patients with severe complication was significantly higher for both 2D-SWE (11.4 kPa vs. 7.0 kPa, p < 0.001) and TE (8.9 kPa vs. 6.2 kPa, p = 0.009). LS obtained from 2D-SWE was a significant factor correlated with severe complication (odds ratio: 1.27 per kPa [1.10-1.46], p = 0.001). The diagnostic performance of 2D-SWE was significantly higher than that of TE in detecting both ≥F3 (p = 0.024) and F4 (p = 0.048). The area under the curve of 2D-SWE to predict severe complication was 0.854, significantly higher than 0.692 of TE (p = 0.004). The optimal cut-off LS from 2D-SWE to predict severe complication was 8.6 kPa, with sensitivity of 88.9% (16/18) and specificity of 73.8% (79/107).
LS obtained from 2D-SWE was a significant predictive factor for severe complication, and 2D-SWE showed significantly a better diagnostic performance than TE in detecting liver fibrosis and severe complication.
• The diagnostic performance of 2D-SWE was significantly higher than that of TE in detecting both ≥ F3 (AUC: 0.853 vs. 0.779, p = 0.024) and F4 (AUC: 0.929 vs. 0.872, p = 0.048). • Liver stiffness value obtained from 2D-SWE was a significant factor correlated with the development of severe complication defined as CCI ≥ 26.2 after hepatic resection for liver tumors (odds ratio: 1.27 per kPa [1.10-1.46], p = 0.001). • 2D-SWE provided significantly a better diagnostic performance in predicting severe complication after hepatic resection than TE (AUC for 2D-SWE: 0.853 vs. AUC for TE: 0.692, p = 0.004).
瞬时弹性成像（TE）和二维剪切波弹性成像（2D-SWE）都是评估肝纤维化的准确方法。我们旨在评估 2D-SWE 预测肝切除术后并发症的诊断性能，并将其与 TE 进行比较。
我们前瞻性地招募了 125 名患有肝脏肿瘤的患者。在手术前使用 TE 和 2D-SWE 测量肝脏硬度（千帕斯卡 [kPa]）。使用综合并发症指数（CCI）评估所有术后并发症，CCI≥26.2 定义为严重并发症。使用逻辑回归分析确定严重并发症的预测因素。使用受试者工作特征（ROC）分析评估 TE/2D-SWE 检测肝纤维化和严重并发症的诊断性能。
18 名患者出现严重并发症。严重并发症患者的 2D-SWE 中位数 LS 明显更高（11.4 kPa 比 7.0 kPa，p<0.001）和 TE（8.9 kPa 比 6.2 kPa，p=0.009）。2D-SWE 获得的 LS 是与严重并发症相关的显著因素（优势比：每千帕 1.27 [1.10-1.46]，p=0.001）。2D-SWE 在检测≥F3（p=0.024）和 F4（p=0.048）方面的诊断性能明显高于 TE。2D-SWE 预测严重并发症的曲线下面积为 0.854，明显高于 TE 的 0.692（p=0.004）。预测严重并发症的最佳 2D-SWE LS 截断值为 8.6 kPa，敏感性为 88.9%（16/18），特异性为 73.8%（79/107）。
2D-SWE 获得的 LS 是严重并发症的显著预测因素，2D-SWE 在检测肝纤维化和严重并发症方面的诊断性能明显优于 TE。
