Argalia Giulio, Ventura Claudio, Tosi Niccolò, Campioni Daniele, Tagliati Corrado, Tufillaro Marianna, Cucco Monica, Svegliati Baroni Gianluca, Giovagnoni Andrea
Departement of Radiological Sciences, Ospedali Riuniti Ancona, Università Politecnica Delle Marche, University Hospital, Via Tronto 10, 60126, Ancona, Italy.
Liver Insult and Transplant Unit, Obesity Center, Ospedali Riuniti Ancona, Università Politecnica Delle Marche, University Hospital, Via Tronto 10, 60126, Ancona, Italy.
Radiol Med. 2022 May;127(5):571-576. doi: 10.1007/s11547-022-01475-8. Epub 2022 Mar 15.
To compare point shear wave elastography (pSWE, ElastPQ®) and transient elastography (TE) with Liver Biopsy in order to evaluate fibrosis stage in non-alcoholic fatty liver disease (NAFLD).
Our prospective study from September 2017 to October 2020 included 50 consecutively enrolled patients with NAFLD (52.2 ± 13.0 years, 32 male). All patients underwent clinical evaluation, B-mode ultrasound, pSWE, TE and liver biopsy in a single evaluation. The clinical, laboratory and liver biopsy data were compared with liver stiffness (LS) measurement obtained with pSWE and TE. TE and pSWE diagnostic accuracy for the diagnosis of the different fibrosis stages were evaluated using the area under receiver operating characteristic curve (AUROC).
Only fibrosis stage was independently associated with TE and pSWE. The median liver stiffness measurement for fibrosis stages F0, F1, F2, F3, and F4 using TE was 4.8 (4.7-6.1) kPa, 5.5 (4.4-7.3) kPa, 7.7 (6.1-9.1) kPa, 9.9 (8.8-13.8) kPa, and 20.2 kPa, respectively. The corresponding median liver stiffness measurement using pSWE was 4.2 (4.0-4.8) kPa, 4.7 (4.2-5.8) kPa, 5.1 (4.1-6.9) kPa, 8.5 (5.2-13.3), and 15.1 kPa, respectively. The AUROC of TE for diagnosis of fibrosis stage F1, ≥ F2, ≥ F3, and F4 were 0.795, 0.867, 0.927, and 0.990, respectively. The corresponding AUROC of pSWE was 0.717, 0.733, 0.908, and 1.000, respectively. No association was observed with other histological parameters.
TE was significantly better than pSWE for the diagnosis of fibrosis stage ≥ F2. No statistically significant differences were found between TE and pSWE AUROC of fibrosis stage ≥ F1, ≥ F3, and F4.
比较点剪切波弹性成像（pSWE，ElastPQ®）和瞬时弹性成像（TE）与肝活检，以评估非酒精性脂肪性肝病（NAFLD）的纤维化阶段。
我们从2017年9月至2020年10月进行的前瞻性研究纳入了50例连续入组的NAFLD患者（52.2±13.0岁，32例男性）。所有患者在一次评估中均接受了临床评估、B超、pSWE、TE和肝活检。将临床、实验室和肝活检数据与通过pSWE和TE获得的肝脏硬度（LS）测量值进行比较。使用受试者操作特征曲线下面积（AUROC）评估TE和pSWE对不同纤维化阶段诊断的准确性。
仅纤维化阶段与TE和pSWE独立相关。使用TE时，纤维化阶段F0、F1、F2、F3和F4的肝脏硬度测量中位数分别为4.8（4.7 - 6.1）kPa、5.5（4.4 - 7.3）kPa、7.7（6.1 - 9.1）kPa、9.9（8.8 - 13.8）kPa和20.2 kPa。使用pSWE时相应的肝脏硬度测量中位数分别为4.2（4.0 - 4.8）kPa、4.7（4.2 - 5.8）kPa、5.1（4.1 - 6.9）kPa、8.5（5.2 - 13.3）和15.1 kPa。TE诊断纤维化阶段F1、≥F2、≥F3和F4的AUROC分别为0.795、0.867、0.927和0.990。pSWE的相应AUROC分别为0.717、0.733、0.908和1.000。未观察到与其他组织学参数的关联。
在诊断纤维化阶段≥F2时，TE明显优于pSWE。在纤维化阶段≥F1、≥F3和F4的TE与pSWE的AUROC之间未发现统计学显著差异。
