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剪切波弥散度评估法在腔静脉连接相关肝病中的应用。

Shear wave dispersion to assess liver disease progression in Fontan-associated liver disease.

机构信息

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.

出版信息

PLoS One. 2022 Jul 8;17(7):e0271223. doi: 10.1371/journal.pone.0271223. eCollection 2022.

Abstract

AIM

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c412/9269959/6c1fad2fb2ad/pone.0271223.g001.jpg

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