Schulz Marten, Kleinjans Moritz, Strnad Pavel, Demir Münevver, Holtmann Theresa M, Tacke Frank, Wree Alexander
Department of Hepatology and Gastroenterology, Campus Virchow-Klinikum (CVK) und Campus Charité Mitte (CCM), Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.
Medical Clinic III, Gastroenterology, Metabolic Diseases, and Intensive Care, University Hospital, RWTH Aachen, 52074 Aachen, Germany.
Diagnostics (Basel). 2021 Mar 31;11(4):629. doi: 10.3390/diagnostics11040629.
Liver affection of Alpha1-antitrypsin deficiency (AATD) can lead to cirrhosis and hepatocellular carcinoma (HCC). A noninvasive severity assessment of liver disease in AATD is urgently needed since laboratory parameters may not accurately reflect the extent of liver involvement. Preliminary data exist on two-dimensional shear wave elastography (2D-SWE) being a suitable method for liver fibrosis measurement in AATD. AATD patients without HCC were examined using 2D-SWE, shear wave dispersion imaging (SWD) and transient elastography (TE). Furthermore, liver steatosis was assessed using the controlled attenuation parameter (CAP) and compared to the new method of attenuation imaging (ATI). 29 AATD patients were enrolled, of which 18 had the PiZZ genotype, eight had PiMZ, two had PiSZ and one had a PiZP-Lowell genotype. 2D-SWE (median 1.42 m/S, range 1.14-1.83 m/S) and TE (median 4.8 kPa, range 2.8-24.6 kPa) values displayed a significant correlation (R = 0.475, < 0.05). 2D-SWE, ATI (median 0.56 dB/cm/MHz, range 0.43-0.96 dB/cm/MHz) and CAP (median 249.5 dB/m, range 156-347 dB/m) values were higher in PiZZ when compared to other AATD genotypes. This study provides evidence that 2D-SWE is a suitable method for the assessment of liver disease in AATD. The newer methods of SWD and ATI require further evaluation in the context of AATD.
α1-抗胰蛋白酶缺乏症（AATD）的肝脏病变可导致肝硬化和肝细胞癌（HCC）。由于实验室参数可能无法准确反映肝脏受累程度，因此迫切需要对AATD患者的肝脏疾病进行非侵入性严重程度评估。已有初步数据表明，二维剪切波弹性成像（2D-SWE）是一种适用于测量AATD患者肝纤维化的方法。对无HCC的AATD患者使用2D-SWE、剪切波频散成像（SWD）和瞬时弹性成像（TE）进行检查。此外，使用受控衰减参数（CAP）评估肝脏脂肪变性，并与衰减成像（ATI）新方法进行比较。纳入了29例AATD患者，其中18例为PiZZ基因型，8例为PiMZ，2例为PiSZ，1例为PiZP-Lowell基因型。2D-SWE（中位数1.42 m/S，范围1.14 - 1.83 m/S）和TE（中位数4.8 kPa，范围2.8 - 24.6 kPa）值显示出显著相关性（R = 0.475，<0.05）。与其他AATD基因型相比，PiZZ基因型患者的2D-SWE、ATI（中位数0.56 dB/cm/MHz，范围0.43 - 0.96 dB/cm/MHz）和CAP（中位数249.5 dB/m，范围156 - 347 dB/m）值更高。本研究提供了证据表明2D-SWE是评估AATD患者肝脏疾病的一种合适方法。SWD和ATI等更新的方法在AATD背景下需要进一步评估。
