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应用 FibroTouch 与 Fibroscan 检测慢性肝病患者的衰减参数与肝硬度值。

Attenuation parameter and liver stiffness measurement using FibroTouch vs Fibroscan in patients with chronic liver disease.

机构信息

Faculty of Medicine, Department of Medicine, Gastroenterology and Hepatology Unit, University of Malaya, Kuala Lumpur, Malaysia.

Department of Nursing Science, University of Malaya, Kuala Lumpur, Malaysia.

出版信息

PLoS One. 2021 May 3;16(5):e0250300. doi: 10.1371/journal.pone.0250300. eCollection 2021.

Abstract

BACKGROUND & AIM: We studied FibroTouch (FT) and Fibroscan (FS) examination results and their repeatability when performed by healthcare personnel of different background.

METHODS

FT and FS examinations were performed on patients with chronic liver disease by two operators, a doctor and a nurse, twice on each patient, at two different time points, independent of each other.

RESULTS

The data for 163 patients with 1304 examinations was analyzed. There was strong correlation between FT and FS for attenuation parameter (Spearman's rho 0.76, p<0.001) and liver stiffness measurement (LSM) (Spearman's rho 0.70, p<0.001). However, FT produced higher value at lower attenuation parameter and LSM, and lower value at higher attenuation parameter and LSM. There was substantial agreement when using 15kPa LSM cut-off, but only moderate agreement when using 10kPa and 20kPa LSM cut-offs and 248dB/m, 268dB/m and 280dB/m attenuation parameter cut-offs. The IQR for attenuation parameter and IQR/median for LSM were significantly lower for FT compared with FS (4dB/m vs 27dB/m, p<0.001, and 10 vs 12, p<0.001, respectively). The intra- and inter-observer reliability of attenuation parameter and LSM using FT and FS were good to excellent with intraclass correlation coefficients 0.89-0.99. FT had shorter examination time (33s vs 47s, p<0.001) and less invalid measurements (0 vs 2, p<0.001).

CONCLUSION

Measurements obtained with FT and FS strongly correlated, but significant differences in their absolute values, consistency, examination time and number of invalid measurements were observed. Either device can be used by healthcare personnel of different backgrounds when sufficiently trained.

摘要

背景与目的

我们研究了 FibroTouch(FT)和 Fibroscan(FS)检查结果及其在不同背景的医护人员进行检查时的可重复性。

方法

由两名操作员(一名医生和一名护士)对慢性肝病患者进行 FT 和 FS 检查,每位患者两次,在两个不同的时间点独立进行。

结果

对 163 名患者的 1304 次检查数据进行了分析。衰减参数(Spearman 相关系数 0.76,p<0.001)和肝硬度测量(LSM)(Spearman 相关系数 0.70,p<0.001)之间 FT 和 FS 之间存在很强的相关性。然而,FT 在较低的衰减参数和 LSM 时产生较高的值,而在较高的衰减参数和 LSM 时产生较低的值。使用 15kPa 的 LSM 截断值时具有实质性一致性,但使用 10kPa 和 20kPa 的 LSM 截断值和 248dB/m、268dB/m 和 280dB/m 的衰减参数截断值时仅具有中度一致性。与 FS 相比,FT 的衰减参数的 IQR 和 LSM 的 IQR/中位数显著较低(4dB/m 与 27dB/m,p<0.001,和 10 与 12,p<0.001,分别)。使用 FT 和 FS 的衰减参数和 LSM 的观察者内和观察者间可靠性均为良好至极好,组内相关系数为 0.89-0.99。FT 的检查时间更短(33s 与 47s,p<0.001),无效测量更少(0 与 2,p<0.001)。

结论

FT 和 FS 获得的测量值高度相关,但观察到它们的绝对值、一致性、检查时间和无效测量数量存在显著差异。经过充分培训,任何设备都可以由不同背景的医护人员使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a597/8092664/0f578cca1eb5/pone.0250300.g001.jpg

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