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慢性病毒性肝炎患者中使用ElastPQ进行肝纤维化的无创评估:与组织病理学结果的比较

Noninvasive Assessment of Liver Fibrosis with ElastPQ in Patients with Chronic Viral Hepatitis: Comparison Using Histopathological Findings.

作者信息

Choo Dongmin, Shin Kyung Sook, Min Ji Hye, You Sun-Kyoung, Kim Kyung-Hee, Lee Jeong Eun

机构信息

Sok Medical Clinic, 586 Gyeryong-ro, Seo-gu, Daejeon 35300, Korea.

Department of Radiology, Chungnam National University Hospital, College of Medicine, Chungnam National University, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea.

出版信息

Diagnostics (Basel). 2022 Mar 14;12(3):706. doi: 10.3390/diagnostics12030706.

Abstract

Chronic viral hepatitis is a major cause of chronic liver disease leading to liver fibrosis. This study aimed to assess the diagnostic performance of elastography point quantification (ElastPQ), transient elastography (TE), and aspartate aminotransferase-to-platelet count ratio index (APRI) for the staging of liver fibrosis in patients with chronic viral hepatitis using histopathological findings as a reference standard. For 122 patients with chronic viral hepatitis, diagnostic performance was evaluated using area under the receiver operating characteristic curve (AUROC) analysis and correlations were determined using Spearman’s correlation coefficient. The AUROC of ElastPQ for the diagnosis of the fibrosis stage ≥ F2 was 0.917 with a cut-off value of 3.935. There was a significant positive correlation between the different stages of histologic liver fibrosis and stiffness values obtained using ElastPQ, TE, and APRI (ρ = 0.556, ρ = 0.657, ρ = 0.375, respectively; p < 0.001). ElastPQ showed a higher diagnostic accuracy than APRI, resembling that of TE; AUROC values of ElastPQ, TE, and APRI were 0.917, 0.964, and 0.896, respectively, for a fibrosis stage ≥ F2. ElastPQ is a promising noninvasive technique with a diagnostic accuracy comparable with that of TE for the evaluation of liver fibrosis in patients with chronic viral hepatitis.

摘要

慢性病毒性肝炎是导致肝纤维化的慢性肝病的主要病因。本研究旨在以组织病理学结果作为参考标准,评估弹性成像点定量(ElastPQ)、瞬时弹性成像(TE)和天冬氨酸转氨酶与血小板计数比值指数(APRI)对慢性病毒性肝炎患者肝纤维化分期的诊断性能。对122例慢性病毒性肝炎患者,采用受试者操作特征曲线下面积(AUROC)分析评估诊断性能,并使用Spearman相关系数确定相关性。ElastPQ诊断纤维化分期≥F2的AUROC为0.917,临界值为3.935。组织学肝纤维化不同分期与使用ElastPQ、TE和APRI获得的硬度值之间存在显著正相关(分别为ρ = 0.556、ρ = 0.657、ρ = 0.375;p < 0.001)。ElastPQ显示出比APRI更高的诊断准确性,与TE相似;对于纤维化分期≥F2,ElastPQ、TE和APRI的AUROC值分别为0.917、0.964和0.896。ElastPQ是一种有前景的非侵入性技术,在评估慢性病毒性肝炎患者肝纤维化方面具有与TE相当的诊断准确性。

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