Department of Gastroenterology and Hepatology, Bonsucesso Federal Hospital.
Oswaldo Cruz Foundation (FIOCRUZ), National Institute of Infectious Diseases Evandro Chagas (INI), Laboratory of Clinical Research in STD/AIDS (LAPCLIN-AIDS).
Eur J Gastroenterol Hepatol. 2022 Aug 1;34(8):873-881. doi: 10.1097/MEG.0000000000002400. Epub 2022 Jun 29.
We aimed to evaluate the agreement/accuracy of point shear-wave elastography (p-SWE) and 2D-shear-wave elastography (2D-SWE) for liver fibrosis staging using transient elastography (TE) as the reference.
This retrospective study analyzed data from people with chronic liver diseases submitted to TE, p-SWE, and 2D-SWE. Liver fibrosis stages were defined using the TE's 'rule of five': normal (<5 kPa); suggestive of compensated-advanced chronic liver disease (cACLD) (10-15 kPa); highly suggestive of cACLD (15-20 kPa); suggestive of clinically significant portal hypertension (>20 kPa). Agreement and accuracy of p-SWE and 2D-SWE were assessed. Optimal cutoffs for p-SWE and 2D-SWE were identified using the point nearest to the upper left corner of the ROC curves.
A total of 289 participants were included. The correlation between TE and 2D-SWE (rho = 0.59; P < 0.001) or p-SWE (rho = 0.69; P < 0.001) was satisfactory. The AUROCs (95% CI) of 2D-SWE and p-SWE for TE ≥ 5 kPa; TE ≥ 10 kPa; TE ≥ 15 kPa and TE ≥ 20 kPa were 0.757 (0.685-0.829) and 0.741 (0.676-0.806); 0.819 (0.770-0.868) and 0.870 (0.825-0.915); 0.848 (0.803-0.893) and 0.952 (0.927-0.978); 0.851 (0.806-0.896) and 0.951 (0.920-0.982), respectively. AUROCs of 2D-SWE were significantly lower compared with p-SWE for detecting cACLD. Optimal thresholds of 2D-SWE and p-SWE for TE ≥ 15 kPa were 8.82 kPa (sensitivity = 86% and specificity = 79%) and 8.86 kPa (sensitivity = 90% and specificity = 92%), respectively.
LSM by p-SWE and 2D-SWE techniques were correlated with TE. LSM by p-SWE seems to be more accurate than 2D-SWE to identify patients with more advanced fibrosis.
本研究旨在评估瞬时弹性成像（TE）作为参考标准时，点剪切波弹性成像（p-SWE）和二维剪切波弹性成像（2D-SWE）对肝纤维化分期的一致性/准确性。
本回顾性研究分析了接受 TE、p-SWE 和 2D-SWE 检查的慢性肝病患者的数据。采用 TE 的“五分制规则”定义肝纤维化分期：正常（<5 kPa）；提示代偿性晚期慢性肝病（cACLD）（10-15 kPa）；高度提示 cACLD（15-20 kPa）；提示临床显著门脉高压（>20 kPa）。评估 p-SWE 和 2D-SWE 的一致性和准确性。使用最接近 ROC 曲线左上角的切点确定 p-SWE 和 2D-SWE 的最佳截断值。
共纳入 289 名参与者。TE 与 2D-SWE（rho = 0.59；P < 0.001）或 p-SWE（rho = 0.69；P < 0.001）之间的相关性令人满意。2D-SWE 和 p-SWE 对 TE≥5 kPa、TE≥10 kPa、TE≥15 kPa 和 TE≥20 kPa 的 AUROCs（95%CI）分别为 0.757（0.685-0.829）和 0.741（0.676-0.806）；0.819（0.770-0.868）和 0.870（0.825-0.915）；0.848（0.803-0.893）和 0.952（0.927-0.978）；0.851（0.806-0.896）和 0.951（0.920-0.982）。2D-SWE 检测 cACLD 的 AUROCs 显著低于 p-SWE。2D-SWE 和 p-SWE 检测 TE≥15 kPa 的最佳截断值分别为 8.82 kPa（灵敏度=86%，特异性=79%）和 8.86 kPa（灵敏度=90%，特异性=92%）。
p-SWE 和 2D-SWE 技术的 LSM 与 TE 相关。p-SWE 的 LSM 似乎比 2D-SWE 更准确地识别出纤维化程度更严重的患者。
