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儿童囊性纤维化和非侵入性肝纤维化评估方法。

Cystic fibrosis and noninvasive liver fibrosis assessment methods in children.

机构信息

Pediatric Hepatology and Gastroenterology Unit, Bordeaux University Hospital, Pellegrin-Enfants Hospital, Bordeaux, France.

Bordeaux University Hospital, Pellegrin-Enfants Hospital, Pediatric Cystic Fibrosis-Center (CRCM), Bordeaux, France.

出版信息

Pediatr Res. 2022 Jan;91(1):223-229. doi: 10.1038/s41390-021-01427-4. Epub 2021 Mar 17.

Abstract

BACKGROUND

Noninvasive assessments of liver fibrosis are currently used to evaluate cystic fibrosis (CF)-related liver disease. However, there is scarce data regarding their repeatability and reproducibility, especially in children with CF. The present study aimed to evaluate the repeatability and reproducibility of transient elastography (TE) (FibroScan®) and point shear-wave elastography using virtual touch quantification (pSWE VTQ) in children with CF.

METHODS

TE and pSWE VTQ were performed in 56 children with CF by two different operators. Analysis of repeatability and reproducibility was available in 33 patients for TE and 46 patients for pSWE VTQ. Intra- and interobserver agreement were assessed using the intraclass correlation coefficient (ICC) and their 95% confidence interval (CI), and Bland and Altman graphs.

RESULTS

For TE, ICC was 0.91 (0.83-0.95) for intraobserver agreement and 0.92 (95% CI: 0.86-0.96) for interobserver agreement. For pSWE VTQ, ICC was 0.83 (0.72-0.90) for intraobserver agreement and 0.67 (0.48-0.80) for interobserver agreement.

CONCLUSIONS

Both technics can be proposed in the follow-up of patients, according to their availability in CF centers.

IMPACT

This study shows that TE and pSWE VTQ are reliable methods to evaluate liver fibrosis in children with CF. This study shows for the first time that TE and pSWE VTQ are both repeatable and reproducible in children with CF. These data indicate that both TE and pSWE VTQ can be proposed for the follow-up of patients with CF, according to their availability in each CF center.

摘要

背景

目前,非侵入性的肝纤维化评估方法被用于评估囊性纤维化(CF)相关的肝病。然而,关于这些方法的重复性和再现性的数据很少,尤其是在 CF 患儿中。本研究旨在评估 CF 患儿中瞬时弹性成像(TE)(FibroScan®)和虚拟触诊定量剪切波弹性成像(pSWE VTQ)的重复性和再现性。

方法

由两名不同的操作者对 56 名 CF 患儿进行 TE 和 pSWE VTQ 检查。分析 TE 的重复性和再现性时,共有 33 例患者纳入,分析 pSWE VTQ 的重复性和再现性时,共有 46 例患者纳入。使用组内相关系数(ICC)及其 95%置信区间(CI)和 Bland-Altman 图评估观察者内和观察者间的一致性。

结果

对于 TE,观察者内一致性的 ICC 为 0.91(0.83-0.95),观察者间一致性的 ICC 为 0.92(95%CI:0.86-0.96)。对于 pSWE VTQ,观察者内一致性的 ICC 为 0.83(0.72-0.90),观察者间一致性的 ICC 为 0.67(0.48-0.80)。

结论

根据 CF 中心的可用性,这两种技术均可用于患者的随访。

意义

本研究表明,TE 和 pSWE VTQ 是评估 CF 患儿肝纤维化的可靠方法。本研究首次表明,TE 和 pSWE VTQ 在 CF 患儿中均具有重复性和再现性。这些数据表明,根据每个 CF 中心的可用性,TE 和 pSWE VTQ 均可用于 CF 患者的随访。

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