Sharpton Suzanne R, Tamaki Nobuharu, Bettencourt Ricki, Madamba Egbert, Jung Jinho, Liu Amy, Behling Cynthia, Valasek Mark A, Loomba Rohit
Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, CA, USA.
NAFLD Research Center, University of California San Diego, La Jolla, CA, USA.
Therap Adv Gastroenterol. 2021 Oct 8;14:17562848211050436. doi: 10.1177/17562848211050436. eCollection 2021.
Two-dimensional shear wave elastography (2D-SWE) and vibration-controlled transient elastography (VCTE) provide noninvasive assessment of hepatic fibrosis. We compared performance of 2D-SWE and VCTE for fibrosis detection in nonalcoholic fatty liver disease (NAFLD).
We performed a prospective study of adults with NAFLD who underwent 2D-SWE, VCTE, and liver biopsy analysis (using Nonalcoholic Steatohepatitis Clinical Research Network scoring system). The primary outcome was hepatic fibrosis (stage ⩾ 1); secondary outcomes included dichotomized fibrosis stages. Area under receiver operating characteristic curve (AUROC) analyses were used to compare 2D-SWE and VCTE performance.
A total of 114 adults with a median BMI of 31.2 kg/m were included. The VCTE was better than 2D-SWE for the detection of fibrosis (AUROC: 0.81 0.72, = 0.03). The VCTE detected fibrosis stage 2, 3, or 4 with AUROCs of 0.86 (95% CI, 0.80-0.93), 0.91 (95% CI, 0.82-0.99), and 0.96 (95% CI, 0.91-1.00). The 2D-SWE detected fibrosis stage 2, 3, or 4 with AUROCs of 0.84 (95% CI, 0.76-0.92), 0.88 (95% CI, 0.81-0.96), and 0.93 (95% CI, 0.86-0.99).
In a prospective study including more than 100 adults with NAFLD, we found VCTE to be more accurate than 2D-SWE in detecting fibrosis; these modalities, however, are comparable in assessing for higher stages of fibrosis.
二维剪切波弹性成像（2D-SWE）和振动控制瞬时弹性成像（VCTE）可对肝纤维化进行无创评估。我们比较了2D-SWE和VCTE在非酒精性脂肪性肝病（NAFLD）中检测纤维化的性能。
我们对患有NAFLD的成年人进行了一项前瞻性研究，这些患者接受了2D-SWE、VCTE和肝活检分析（使用非酒精性脂肪性肝炎临床研究网络评分系统）。主要结局是肝纤维化（分期⩾1）；次要结局包括二分法纤维化分期。采用受试者操作特征曲线下面积（AUROC）分析来比较2D-SWE和VCTE的性能。
共纳入114名成年人，中位体重指数为31.2kg/m。在检测纤维化方面，VCTE优于2D-SWE（AUROC：0.81对0.72，P = 0.03）。VCTE检测纤维化2期、3期或4期的AUROC分别为0.86（95%CI，0.80-0.93）、0.91（95%CI，0.82-0.99）和0.96（95%CI，0.91-1.00）。2D-SWE检测纤维化2期、3期或4期的AUROC分别为0.84（95%CI，0.76-0.92）、0.88（95%CI，0.81-0.96）和0.93（95%CI，0.86-0.99）。
在一项纳入100多名NAFLD成年人的前瞻性研究中，我们发现VCTE在检测纤维化方面比2D-SWE更准确；然而，这些方法在评估更高阶段的纤维化方面具有可比性。
