肝脏二维剪切波弹性成像伪像。
Artifacts in two-dimensional shear wave elastography of liver.
机构信息
Department of Ultrasound, The First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China.
出版信息
World J Gastroenterol. 2023 Jun 7;29(21):3318-3327. doi: 10.3748/wjg.v29.i21.3318.
BACKGROUND
Artifacts are common when using two-dimensional shear wave elastography (2-D SWE) to measure liver stiffness (LS), but they are poorly recognized.
AIM
To investigate the presence and influence of artifacts in 2-D SWE of liver.
METHODS
We included 158 patients with chronic liver disease, who underwent 2-D SWE examination by a novice and an expert. A cross line at the center of the elastogram was drawn and was divided it into four locations: top-left, top-right, bottom-left, and bottom-right. The occurrence frequency of artifacts in different locations was compared. The influence of artifacts on the LS measurements was evaluated by comparing the elastogram with the most artifacts (EMA) and the elastogram with the least artifacts (ELA).
RESULTS
The percentage of elastograms with artifacts in the novice (51.7%) was significantly higher than that of the expert (19.6%) ( < 0.001). It was found that both operators had the highest frequency of artifacts at bottom-left, followed by top-left and bottom-right, and top-right had the lowest frequency. The LS values (LSVs) and standard deviation values of EMAs were significantly higher than those of ELAs for both operators. An intraclass correlation coefficient value of 0.96 was found in the LSVs of EMAs of the two operators, and it increased to 0.98 when the LSVs of the ELAs were used. Both operators had lower stability index values for EMAs than ELAs, but the difference was only statistically significant for the novice.
CONCLUSION
Artifacts are common when using 2-D SWE to measure LS, especially for the novice. Artifacts may lead to the overestimation of LS and reduce the repeatability and reliability of LS measurements.
背景
在使用二维剪切波弹性成像（2-D SWE）测量肝脏硬度（LS）时，伪影很常见，但识别率较差。
目的
探讨 2-D SWE 测量肝脏时伪影的存在及其影响。
方法
我们纳入了 158 例慢性肝病患者，由新手和专家分别进行 2-D SWE 检查。在弹性图的中心画一条交叉线，并将其分为四个位置：左上、右上、左下和右下。比较不同位置伪影的发生频率。通过比较伪影最多的弹性图（EMA）和伪影最少的弹性图（ELA），评估伪影对 LS 测量的影响。
结果
新手的弹性图中存在伪影的比例（51.7%）显著高于专家（19.6%）（<0.001）。结果发现，两位操作者的左下角伪影频率最高，其次是左上角和右下角，右上角伪影频率最低。两位操作者的 EMA 的 LS 值（LSVs）和标准偏差值均显著高于 ELA。两位操作者的 EMA 的 LSVs 的组内相关系数值为 0.96，当使用 ELA 的 LSVs 时，该值增加到 0.98。两位操作者的 EMA 的稳定性指数值均低于 ELA，但仅新手的差异具有统计学意义。
结论
使用 2-D SWE 测量 LS 时伪影很常见，尤其是对新手。伪影可能导致 LS 的高估，并降低 LS 测量的重复性和可靠性。
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