Department of Gastroenterology and Hepatology, ''Victor Babeș'' University of Medicine and Pharmacy, Timișoara, România.
Med Ultrason. 2021 Aug 11;23(3):257-264. doi: 10.11152/mu-2863. Epub 2021 Mar 1.
We aimed to compare the diagnostic performance of two 2D-Shear Wave Elastography (2D-SWE) techniques for the non-invasive assessment of liver fibrosis in patients with chronic hepatitis C virus (HCV) infection using Transient Elas-tography (TE) as reference.
We enrolled 208 consecutive patients with chronic HCV infection, in which liver stiffness (LS) was evaluated in the same session using two 2D-SWE techniques: 2D-SWE.GE and 2D-SWE.SSI using TE as the method of reference. LS measurements were considered failures when no value was obtained after 10 attempts.
Valid LSMs were obtained in 95.6% (199/208) of cases by 2D-SWE.GE, 92.7% (193/208) of cases by 2D-SWE.SSI, and in 94.7% (197/208) of cases by TE (p>0.05). The mean LS values by 2D-SWE.GE were significantly lower than those obtained by 2D-SWE.SSI: 10.3±3.8 kPa vs. 15±10.4 kPa (p<0.0001). 2D-SWE.GE LSMs correlated better with TE than 2D-SWE.SSI (r=0.75, p<0.0001 vs. r=0.57, p<0.0001, z test p=0.0012). Linear regression analysis showed a moderate correlation between LSMs obtained by 2D-SWE.GE and 2D-SWE.SSI (r=0.63, R2=0.4, P<0.0001). Pairwise comparison of receiver operating characteristics curves (ROC) found no significant differences between 2D-SWE.GE and 2D-SWE.SSI in identifying F≥2 fibrosis (0.97 vs. 0.96, P = 0.5650), F≥3 (0.97 vs. 0.95, P = 0.2935), or F=4 (0.97 vs. 0.96, p = 0.6914).
Both 2D-SWE techniques had good feasibility for the noninvasive assessment of liver fibrosis. LS values obtained by 2D-SWE.GE were significantly lower than those obtained by 2D-SWE.SSI. No significant differences were found between both methods in staging liver fibrosis in patients with chronic HCV.
本研究旨在使用瞬时弹性成像(TE)作为参考,比较两种二维剪切波弹性成像(2D-SWE)技术在慢性丙型肝炎病毒(HCV)感染患者中评估肝纤维化的无创诊断性能。
我们纳入了 208 例连续的慢性 HCV 感染患者,使用两种 2D-SWE 技术(2D-SWE.GE 和 2D-SWE.SSI)在同一时段评估肝硬度(LS),TE 作为参考方法。如果尝试 10 次后仍未获得 LS 值,则视为测量失败。
通过 2D-SWE.GE 获得了 95.6%(199/208)的有效 LS 值,通过 2D-SWE.SSI 获得了 92.7%(193/208)的有效 LS 值,通过 TE 获得了 94.7%(197/208)的有效 LS 值(p>0.05)。2D-SWE.GE 的 LS 值明显低于 2D-SWE.SSI:10.3±3.8 kPa 比 15±10.4 kPa(p<0.0001)。2D-SWE.GE 的 LS 值与 TE 的相关性优于 2D-SWE.SSI(r=0.75,p<0.0001 比 r=0.57,p<0.0001,z 检验 p=0.0012)。线性回归分析显示 2D-SWE.GE 和 2D-SWE.SSI 的 LS 值之间存在中度相关性(r=0.63,R2=0.4,P<0.0001)。受试者工作特征曲线(ROC)的成对比较发现 2D-SWE.GE 和 2D-SWE.SSI 在识别 F≥2 纤维化(0.97 比 0.96,P=0.5650)、F≥3(0.97 比 0.95,P=0.2935)或 F=4(0.97 比 0.96,P=0.6914)时无显著差异。
两种 2D-SWE 技术均具有良好的可行性,可用于无创评估肝纤维化。2D-SWE.GE 获得的 LS 值明显低于 2D-SWE.SSI。在慢性 HCV 患者中,两种方法在肝纤维化分期方面无显著差异。