Division of Hepatology, Department of Internal Medicine, Iwate Medical University, Yahaba-cho, Shiwa-gun, Iwate, Japan.
Department of Pediatrics, Iwate Medical University, Yahaba-cho, Shiwa-gun, Iwate, Japan.
PLoS One. 2022 Jul 8;17(7):e0271223. doi: 10.1371/journal.pone.0271223. eCollection 2022.
We aimed to analyze the dispersion slope (DS) using shear wave dispersion (SWD) in patients with Fontan-associated liver disease (FALD) and to investigate its utility as a biomarker of disease progression.
This cross-sectional study enrolled 27 adults with FALD who underwent SWD, two-dimensional shear wave elastography (2D-SWE), transthoracic echocardiography, cardiac catheterization, or abdominal computed tomography (CT) from April 2019 to April 2021. According to CT findings, patients were divided into two groups: significant fibrosis and non-significant fibrosis.
The median DS in the control (n = 10), non-significant fibrosis (n = 12), and significant fibrosis (n = 15) was 9.35, 12.55, and 17.64 (m/s)/kHz, respectively. The significant fibrosis group showed a significantly higher DS than non-significant fibrosis group (P = 0.003). DS showed a significant correlation with central venous pressure (r = 0.532, P = 0.017) and liver stiffness measurements using 2D-SWE (r = 0.581, P = 0.002). The areas under the receiver operating characteristic curve for the diagnosis of significant fibrosis were 0.903 and 0.734 for SWD and 2D-SWE, respectively (P = 0.043).
DS measured by SWD reflects the severity of liver damage in patients with FALD. SWE may be valuable for the therapeutic management of patients with FALD.
分析 Fontan 相关肝疾病(FALD)患者的剪切波速分散度(DS),并探讨其作为疾病进展生物标志物的应用价值。
本横断面研究纳入了 2019 年 4 月至 2021 年 4 月期间接受剪切波速分散度(SWD)、二维剪切波弹性成像(2D-SWE)、经胸超声心动图、心导管检查或腹部计算机断层扫描(CT)的 27 例 FALD 成人患者。根据 CT 结果,患者分为两组:有意义纤维化组和无意义纤维化组。
对照组(n=10)、无意义纤维化组(n=12)和有意义纤维化组(n=15)的中位 DS 分别为 9.35、12.55 和 17.64(m/s)/kHz。有意义纤维化组的 DS 显著高于无意义纤维化组(P=0.003)。DS 与中心静脉压(r=0.532,P=0.017)和 2D-SWE 的肝硬度测量值(r=0.581,P=0.002)呈显著相关性。SWD 和 2D-SWE 诊断有意义纤维化的受试者工作特征曲线下面积分别为 0.903 和 0.734(P=0.043)。
SWD 测量的 DS 反映了 FALD 患者肝脏损伤的严重程度。SWE 可能对 FALD 患者的治疗管理有价值。