Post-Graduate Program in Medicine and Health Science, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
Departament of Radiology, Hospital São Lucas/Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
PLoS One. 2023 Feb 2;18(2):e0271572. doi: 10.1371/journal.pone.0271572. eCollection 2023.
The hepatic diseases are extremely common in clinical practice. The correct classification of liver fibrosis is extremely important, as it influences therapy and predicts disease outcomes. The purpose of this study is to compare the diagnostic performance of point-shear wave elastography (pSWE) and magnetic resonance elastography (MRE) in the hepatic fibrosis diagnostic. A meta-analysis was carried out based on articles published until October 2020. The articles are available at following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Scientific Electronic Library Online, LILACS, Scopus, and CINAHL. Diagnostic performances were analyzed per METAVIR F2, using 3.5kPa as target fibrosis. Assessment of the methodological quality of the incorporated papers by the QUADAS-2 tool for pSWE and MRE. A total 2,153 studies articles were evaluated and 44 studies, comprising 6,081 patients with individual data, were included in the meta-analysis: 28 studies for pSWE and 16 studies for MRE. The pooled sensitivity and specificity were 0.86 (95%CI 0.80-0.90) and 0.88 (95%CI 0.85-0.91), respectively, for pSWE, compared with 0.94 (95%CI 0.89-0.97) and 0.95 (95%CI 0.89-0.98) respectively, for MRE. The pooled SROC curve for pSWE shows in the area under the curve (AUC) of 0.93 (95%CI 0.90-0.95), whereas the AUC for MRE was 0.98 (95%CI 0.96-0.99). The diagnostic odds ratio for pSWE and MRE were 41 (95%CI 24-72) and 293 (95%CI 86-1000), respectively. There was statistically significant heterogeneity for pSWE sensitivity (I² = 85.26, P<0.001) and specificity (I² = 89.46, P<0.001). The heterogeneity for MRE also was significant for sensitivity (I² = 73.28, P<0.001) and specificity (I² = 87.24, P<0.001). Therefore, both pSWE and MRE are suitable modalities for assessing liver fibrosis. In addition, MRE is a more accurate imaging technique than pSWE and can be used as alternative to invasive biopsy.
肝脏疾病在临床实践中极为常见。正确的肝纤维化分类非常重要，因为它会影响治疗方法并预测疾病结局。本研究旨在比较剪切波弹性成像（pSWE）和磁共振弹性成像（MRE）在肝纤维化诊断中的诊断性能。根据截至 2020 年 10 月发表的文章进行了荟萃分析。可在以下数据库中获取这些文章：MEDLINE、EMBASE、Cochrane 对照试验中心注册库、科学电子图书馆在线、LILACS、Scopus 和 CINAHL。使用 3.5kPa 作为目标纤维化，根据 METAVIR F2 对文章进行诊断性能分析。使用 QUADAS-2 工具评估纳入研究的方法学质量。评估了 2153 篇研究文章，纳入了 44 项研究，共纳入 6081 名患者的个体数据，其中 28 项研究为 pSWE，16 项研究为 MRE。pSWE 的汇总敏感性和特异性分别为 0.86（95%CI 0.80-0.90）和 0.88（95%CI 0.85-0.91），而 MRE 分别为 0.94（95%CI 0.89-0.97）和 0.95（95%CI 0.89-0.98）。pSWE 的汇总 SROC 曲线显示曲线下面积（AUC）为 0.93（95%CI 0.90-0.95），而 MRE 的 AUC 为 0.98（95%CI 0.96-0.99）。pSWE 和 MRE 的诊断比值比分别为 41（95%CI 24-72）和 293（95%CI 86-1000）。pSWE 敏感性（I² = 85.26，P<0.001）和特异性（I² = 89.46，P<0.001）存在统计学显著异质性。MRE 的敏感性（I² = 73.28，P<0.001）和特异性（I² = 87.24，P<0.001）也存在显著异质性。因此，pSWE 和 MRE 都是评估肝纤维化的合适方法。此外，MRE 是一种比 pSWE 更准确的成像技术，可作为侵入性活检的替代方法。
