在巴西里约热内卢，以瞬时弹性成像为参考，评估二维剪切波弹性成像在慢性病毒性肝炎和HIV感染中的准确性和一致性。
Accuracy and concordance of two-dimensional shear-wave elastography using transient elastography as the reference in chronic viral hepatitis and HIV infection in Rio de Janeiro, Brazil.
作者信息
Coelho Mariana, Fernandes Flavia, Cardoso Sandra W, Piedade Juliana, Torres da Silva Marcos Vinícius, Santos Ricardo, Veloso Valdilea G, Grinsztejn Beatriz, Pereira Gustavo Henrique, Perazzo Hugo
机构信息
Laboratory of Clinical Research in STD/AIDS (LAPCLIN-AIDS), Oswaldo Cruz Foundation (FIOCRUZ), National Institute of Infectious Diseases Evandro Chagas (INI).
Hepatology Department, Bonsucesso Federal Hospital.
出版信息
Eur J Gastroenterol Hepatol. 2023 May 1;35(5):583-590. doi: 10.1097/MEG.0000000000002537. Epub 2023 Mar 18.
OBJECTIVES
Evaluate the accuracy and agreement of two-dimensional shear-wave elastography (2D-SWE) LOGIQ-S8 with transient elastography in patients from Rio de Janeiro, Brazil.
METHOD
This retrospective study compared liver stiffness measurements (LSMs) using transient elastography (M and XL probes) and 2D-SWE GE-LOGIQ-S8 performed by a single experienced operator on the same day in 348 consecutive individuals with viral hepatitis or HIV infection. Suggestive and highly suggestive compensated-advanced chronic liver disease (c-ACLD) were defined by transient elastography-LSM ≥10 kPa and ≥15 kPa, respectively. Agreement between techniques and accuracy of 2D-SWE using transient elastography-M probe as the reference was assessed. Optimal cut-offs for 2D-SWE were identified using the maximal Youden index.
RESULTS
Three hundred five patients [61.3% male, median age = 51 [interquartile range (IQR), 42-62] years, 24% with hepatitis C virus (HCV) ± HIV; 17% with hepatitis B virus (HBV) ± HIV; 31% were HIV mono-infected and 28% had HCV ± HIV post-sustained virological response] were included. The overall correlation (Spearman's ρ ) was moderate between 2D-SWE and transient elastography-M ( ρ = 0.639) and weak between 2D-SWE and transient elastography-XL ( ρ = 0.566). Agreements were strong ( ρ > 0.800) in people with HCV or HBV mono-infection, and poor in HIV mono-infected ( ρ > 0.400). Accuracy of 2D-SWE for transient elastography-M ≥ 10 kPa [area under the receiver operating characteristic (AUROC) = 0.91 (95% confidence interval [CI], 0.86-0.96); optimal cut-off = 6.4 kPa, sensitivity = 84% (95% CI, 72-92), specificity = 89% (95% CI, 84-92)] and for transient elastography-M ≥ 15 kPa [AUROC = 0.93 (95% CI, 0.88-0.98); optimal cut-off = 7.1 kPa; sensitivity = 91% (95% CI, 75-98), specificity = 89% (95% CI, 85-93)] were excellent.
CONCLUSION
2D-SWE LOGIQ-S8 system had a good agreement with transient elastography and an excellent accuracy to identify individuals at high risk for c-ACLD.
目的
评估巴西里约热内卢患者中，二维剪切波弹性成像（2D-SWE）LOGIQ-S8与瞬时弹性成像的准确性和一致性。
方法
这项回顾性研究比较了在同一天，由同一位经验丰富的操作人员，使用瞬时弹性成像（M和XL探头）和2D-SWE GE-LOGIQ-S8对348例连续性病毒型肝炎或HIV感染患者进行的肝脏硬度测量（LSM）。提示性和高度提示性代偿期晚期慢性肝病（c-ACLD）分别由瞬时弹性成像-LSM≥10kPa和≥15kPa定义。以瞬时弹性成像-M探头为参考，评估了两种技术之间的一致性以及2D-SWE的准确性。使用最大约登指数确定2D-SWE的最佳截断值。
结果
纳入305例患者[男性占61.3%，中位年龄=51岁（四分位间距[IQR]，42 - 62岁），24%为丙型肝炎病毒（HCV）±HIV；17%为乙型肝炎病毒（HBV）±HIV；31%为HIV单感染，28%为HCV±HIV持续病毒学应答后患者]。2D-SWE与瞬时弹性成像-M之间的总体相关性（Spearman氏ρ）为中等（ρ = 0.639），2D-SWE与瞬时弹性成像-XL之间的相关性较弱（ρ = 0.566）。HCV或HBV单感染患者的一致性较强（ρ > 0.800），HIV单感染患者的一致性较差（ρ > 0.400）。对于瞬时弹性成像-M≥10kPa，2D-SWE的准确性[受试者操作特征曲线下面积（AUROC）= 0.91（95%置信区间[CI]，0.86 - 0.96）；最佳截断值= 6.4kPa，敏感性= 84%（95%CI，72 - 92），特异性= 89%（95%CI，84 - 92）]以及对于瞬时弹性成像-M≥15kPa，2D-SWE的准确性[AUROC = 0.93（95%CI，0.88 - 0.98）；最佳截断值= 7.1kPa；敏感性= 91%（95%CI，75 - 98），特异性= 89%（95%CI，85 - 93）]均极佳。
结论
2D-SWE LOGIQ-S8系统与瞬时弹性成像具有良好的一致性，并且在识别c-ACLD高危个体方面具有出色的准确性。
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