Beijing Youan Hospital, Capital Medical University, No 8, Xitoutiao, Youanmenwai, Fengtai District, Beijing, 100069, China.
Handan Infectious Disease Hospital, Congtai District, No. 472, Heping Road, Handan, China.
Eur Radiol. 2024 Feb;34(2):770-779. doi: 10.1007/s00330-023-10106-3. Epub 2023 Aug 22.
To analyze the diagnostic efficacy of the periportal hypoechoic band (PHB) in the histological stage of patients with primary biliary cholangitis (PBC).
We prospectively included 77 cases of PBC pathologically or clinically confirmed, and high-frequency ultrasound (HFUS) measurements of the PHB were performed in all included patients. Ludwig staging system of histopathology was used as the gold standard.
The width of the PHB was positively correlated with histological staging (r = 0.844, p < 0.001). By area under the receiving operating characteristic curve (AUROC), the best cutoff value for PHB for advanced stage (≥ stage 3) was 2.4 mm (AUROC: 0.934; 95%CI: 0.841-0.981) and 0.93 for sensitivity, and 0.91 for specificity, the concordance rates of PHB vs. liver biopsy was 90.3%. The correct rate for early-stage PBC was 87.9% and for the progressive stage was 93.1%. After multi-factor regression analysis, the PHB (OR = 1.331, CI = 1.105-1.603, p = 0.003) and total bilirubin (OR = 1.156, CI = 1.041-1.285, p = 0.007) were independent influencing factors for progressive PBC.
Measurement of the PHB to assess advanced PBC is a simple and effective method. This method may complement current methods for the histological staging assessment of patients with PBC.
Clinical trial registration: ChiCTR 2000032053, 2020/04/19.
The measurement of periportal hypoechoic band (PHB) provides a simple and easy assessment of the degree of disease progression in patients with PBC and provides an important clinical reference in predicting the histological staging of PBC from an ultrasound perspective.
• The PHB is correlated with histological staging in the patient with PBC. • The area under the ROC curves of PHB for detecting advanced stage (≥ stage 3) were 0.934 and 0.93 for sensitivity, and 0.91 for specificity, the concordance rates of PHB vs. liver biopsy was 90.3%. The application of PHB can better assess the advanced PBC. • Measurement of the PHB to assess advanced PBC is a simple and effective method that can significantly reduce the need for liver biopsy.
分析原发性胆汁性胆管炎（PBC）患者组织学分期中门静脉周围低回声带（PHB）的诊断效能。
前瞻性纳入 77 例经病理或临床证实的 PBC 患者，对所有纳入患者均行高频超声（HFUS）测量 PHB。采用 Ludwig 组织病理学分期系统作为金标准。
PHB 宽度与组织学分期呈正相关（r=0.844，p<0.001）。通过接受者操作特征曲线（ROC）下面积（AUROC），PHB 诊断晚期（≥ 3 期）的最佳截断值为 2.4mm（AUROC：0.934；95%CI：0.841-0.981），敏感度为 0.93，特异度为 0.91，PHB 与肝活检的一致性率为 90.3%。早期 PBC 的准确率为 87.9%，进展期准确率为 93.1%。多因素回归分析显示，PHB（OR=1.331，CI=1.105-1.603，p=0.003）和总胆红素（OR=1.156，CI=1.041-1.285，p=0.007）是 PBC 进展的独立影响因素。
测量 PHB 评估晚期 PBC 是一种简单有效的方法。该方法可能补充了目前 PBC 患者组织学分期评估的方法。
临床试验注册：ChiCTR2000032053，2020/04/19。
门静脉周围低回声带（PHB）的测量为 PBC 患者疾病进展程度提供了一种简单易行的评估方法，为从超声角度预测 PBC 的组织学分期提供了重要的临床参考。
PHB 与 PBC 患者的组织学分期相关。
PHB 检测晚期（≥ 3 期）的 ROC 曲线下面积为 0.934，敏感度为 0.93，特异度为 0.91，PHB 与肝活检的一致性率为 90.3%。PHB 的应用可以更好地评估晚期 PBC。
测量 PHB 评估晚期 PBC 是一种简单有效的方法，可显著减少肝活检的需求。
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