Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Curr Med Imaging. 2023;19(11):1258-1272. doi: 10.2174/1573405618666220829152956.
Few studies comprehensively compared the performance of transient elastography (TE) and two-dimensional shear wave elastography(2D-SWE) to diagnose the stage of liver fibrosis in children and adolescents. We assessed the diagnostic performance of these non-invasive imaging techniques from published studies.
To evaluate the diagnostic performance of TE and 2D-SWE, we searched the PubMed, Embase, Web of Science, and Cochrane Library databases until November 13, 2021, for studies that diagnosed liver fibrosis in children and adolescents. Pooled sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratios, and area under the receiver operating characteristic curve were estimated using the bivariate model. We also performed a subgroup analysis of various research characteristics.
Twenty-seven studies with 1956 patients were included in the analysis. The sensitivity and specificity of TE and 2D-SWE for detecting liver fibrosis in all stages were greater than 0.82. For the detection of significant fibrosis, advanced fibrosis and cirrhosis, the summary AUC was 0.90 (95% CI: 0.87-0.92), 0.95 (95% CI: 0.93-0.96) and 0.95 (95% CI: 0.93-0.97) for TE, and the summary AUC was 0.92 (95% CI: 0.89-0.94), 0.94 (95% CI: 0.92-0.96) and 0.96 (95% CI: 0.94-0.97) for 2D-SWE, respectively. Both imaging methods detected significant heterogeneity.
TE and 2D-SWE can provide accurate non-invasive staging of liver fibrosis in children or adolescents and are a promising technology, particularly for advanced liver fibrosis and cirrhosis, with a high potential to replace liver biopsy.
很少有研究全面比较瞬时弹性成像（TE）和二维剪切波弹性成像（2D-SWE）在诊断儿童和青少年肝纤维化分期方面的性能。我们评估了这些非侵入性成像技术在已发表研究中的诊断性能。
为了评估 TE 和 2D-SWE 的诊断性能，我们检索了 PubMed、Embase、Web of Science 和 Cochrane Library 数据库，截至 2021 年 11 月 13 日，以获取诊断儿童和青少年肝纤维化的研究。使用双变量模型估计汇总敏感性、特异性、阳性和阴性似然比、诊断优势比和受试者工作特征曲线下面积。我们还对各种研究特征进行了亚组分析。
共纳入 27 项研究，包含 1956 例患者。TE 和 2D-SWE 检测所有阶段肝纤维化的敏感性和特异性均大于 0.82。对于检测显著纤维化、进展性纤维化和肝硬化，TE 的汇总 AUC 为 0.90（95%CI：0.87-0.92）、0.95（95%CI：0.93-0.96）和 0.95（95%CI：0.93-0.97），2D-SWE 的汇总 AUC 分别为 0.92（95%CI：0.89-0.94）、0.94（95%CI：0.92-0.96）和 0.96（95%CI：0.94-0.97）。两种成像方法均检测到显著的异质性。
TE 和 2D-SWE 可准确提供儿童或青少年肝纤维化的非侵入性分期，是一种很有前途的技术，尤其适用于进展性肝纤维化和肝硬化，具有取代肝活检的高潜力。
