Xiong Yu, Xin Yuwei, Liu Feifei, Li Wenxue, Liu Yiqun, Zhu Jia'an
Department of Ultrasound, Peking University People's Hospital, Beijing, China.
Department of Ultrasound, Binzhou Medical University Hospital, Binzhou, China.
Quant Imaging Med Surg. 2022 Nov;12(11):5044-5055. doi: 10.21037/qims-22-374.
To investigate the feasibility of using shear wave dispersion (SWD) imaging to evaluate hepatic acute graft-versus-host disease (aGVHD) in a rat model.
To establish an aGVHD model, 30 Wistar rats were subjected to bone marrow transplantation, 10 Fischer 344 rats were used as donors, and 6 Wistar rats were used as the control group. Each week, 6 rats were randomly chosen and divided into groups of 1 week (1 w) to 5 weeks (5 w). For each subgroup, the rats received a clinical index assessment and shear wave dispersion (SWD) examination with 2 quantitative values, shear wave (SW) speed and SWD slope. The histological characteristics were then used as the reference standard to divide the rats into the aGVHD group and the no aGVHD (nGVHD) group.
In the 2 weeks (2 w) group, only SWD slope [median: 7.26, interquartile range (IQR): 7.04 to 7.31] showed a significant increase in the measured value (P<0.05). The value of the 3 weeks (3 w) group (median: 7.88, IQR: 7.84 to 8.49) significantly increased compared with the 2 w value (P<0.05). Although the value increased gradually from week 3 to week 5, it had no statistical significance (P>0.05). The SW speed [mean ± standard deviation (SD): 1.54±0.11, 95% confidence interval (CI): 1.48 to 1.59] and SWD slope (mean ± SD: 8.29±0.56, 95% CI: 7.99 to 8.59) of the aGVHD group were higher than those of the control group and the nGVHD group (P<0.001). The correlation of SWD slope with pathological grade was the highest (r=0.798, P<0.01), followed by SW speed (r=0.785, P<0.01), and the correlation of clinical index with pathological grade was the lowest (r=0.751, P<0.01). In addition, the area under the receiver operating characteristic (ROC) curve (AUC) value of aGVHD using the SWD slope was 0.844 (95% CI: 0.67 to 0.95, sensitivity: 93.75%, specificity: 78.57%), which was higher than the AUC of both SW speed and clinical index, and the difference was statistically significant compared to the AUC of the clinical index.
The SWD slope could show significant abnormalities earlier than SW speed and clinical index and is also more consistent with the change in aGVHD severity level. The SWD slope may help in detecting hepatic aGVHD during ultrasound SWD examination.
探讨使用剪切波频散（SWD）成像评估大鼠模型中肝脏急性移植物抗宿主病（aGVHD）的可行性。
为建立aGVHD模型，30只Wistar大鼠接受骨髓移植，10只Fischer 344大鼠作为供体，6只Wistar大鼠作为对照组。每周随机选取6只大鼠，分为1周（1w）至5周（5w）组。对于每个亚组，大鼠接受临床指标评估和具有两个定量值（剪切波（SW）速度和SWD斜率）的剪切波频散（SWD）检查。然后将组织学特征作为参考标准，将大鼠分为aGVHD组和无aGVHD（nGVHD）组。
在2周（2w）组中，仅SWD斜率[中位数：7.26，四分位间距（IQR）：7.04至7.31]显示测量值显著增加（P<0.05）。3周（3w）组的值（中位数：7.88，IQR：7.84至8.49）与2w组的值相比显著增加（P<0.05）。尽管该值从第3周逐渐增加到第5周，但无统计学意义（P>0.05）。aGVHD组的SW速度[平均值±标准差（SD）：1.54±0.11，95%置信区间（CI）：1.48至1.59]和SWD斜率（平均值±SD：8.29±0.56，95%CI：7.99至8.59）高于对照组和nGVHD组（P<0.001）。SWD斜率与病理分级的相关性最高（r=0.798，P<0.01），其次是SW速度（r=0.785，P<0.01），临床指标与病理分级的相关性最低（r=0.751，P<0.01）。此外，使用SWD斜率的aGVHD受试者工作特征（ROC）曲线下面积（AUC）值为0.844（95%CI：0.67至0.95，敏感性：93.75%，特异性：78.57%），高于SW速度和临床指标的AUC，与临床指标的AUC相比差异有统计学意义。
SWD斜率比SW速度和临床指标更早显示出显著异常，并且也与aGVHD严重程度水平的变化更一致。SWD斜率可能有助于在超声SWD检查期间检测肝脏aGVHD。
