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振动控制瞬时弹性成像作为非酒精性脂肪性肝病患者肝纤维化无创评估的诊断准确性

Diagnostic Accuracy of Vibration Controlled Transient Elastography as Non-invasive Assessment of Liver Fibrosis in Patients with Non-alcoholic Fatty Liver Disease.

作者信息

Salehi Hossain, Salehi Amir Mohammad, Ghamarchehreh Mohammad Ebrahim, Khanlarzadeh Elham, Sohrabi Masoud Reza

机构信息

Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Student Research Committee, Hamadan University of Medical Sciences School of Medicine, Hamadan, Iran.

出版信息

Middle East J Dig Dis. 2023 Jan;15(1):26-31. doi: 10.34172/mejdd.2023.316. Epub 2023 Jan 30.

Abstract

Liver biopsy remain as the gold standard for diagnosing hepatic fibrosis; however, it has some limitations, such as life-threatening complications, low acceptance by the patients, and variations in the related sample. Therefore, there is a need for the development of non-invasive investigations for diagnosing hepatic fibrosis. Vibration-controlled transient elastography (VCTE) is one of these non-invasive methods. This study included 73 patients suffering from non-alcoholic fatty liver disease (NAFLD) who were older than 18 years. The patients underwent VCTE at the Baqiatallah and Firoozgar hospitals. Then, they underwent a liver biopsy by an experienced radiologist in the same hospital. A receiver operating characteristic (ROC) curve of different fibrosis stages was used to evaluate the VCTE verification. VCTE could detect any fibrosis levels (stage 1 and higher) with an area under the ROC curve (AUROC) of 0.381. Moreover, it detected stage 2-4 fibrosis with an AUROC of 0.400, stage 3-4 fibrosis with an AUROC of 0.687, and stage 4 fibrosis with an AUROC of 0.984. The VCTE has high clinical validity in diagnosing the advanced stages of fibrosis (stages 3, 4) and can be a suitable alternative to the invasive method of liver biopsy with high reliability.

摘要

肝活检仍然是诊断肝纤维化的金标准;然而,它存在一些局限性,如危及生命的并发症、患者接受度低以及相关样本的差异。因此,需要开发用于诊断肝纤维化的非侵入性检查方法。振动控制瞬时弹性成像(VCTE)就是这些非侵入性方法之一。本研究纳入了73例年龄超过18岁的非酒精性脂肪性肝病(NAFLD)患者。这些患者在巴基耶塔拉医院和菲鲁兹加尔医院接受了VCTE检查。然后,由同一家医院经验丰富的放射科医生为他们进行肝活检。使用不同纤维化阶段的受试者操作特征(ROC)曲线来评估VCTE的验证情况。VCTE能够检测出任何纤维化水平(1期及更高),ROC曲线下面积(AUROC)为0.381。此外,它检测2 - 4期纤维化的AUROC为0.400,检测3 - 4期纤维化的AUROC为0.687,检测4期纤维化的AUROC为0.984。VCTE在诊断晚期纤维化(3期、4期)方面具有较高的临床有效性,并且可以成为具有高可靠性的侵入性肝活检方法的合适替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6da/10404076/e693f84afc30/mejdd-15-26-g001.jpg

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