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联合弹性成像评估胆汁淤积性肝病患儿肝纤维化程度

Combi-Elasto Evaluation of the Degree of Liver Fibrosis in Children with Cholestatic Liver Disease.

作者信息

Li Rina, Hu Caihui, Xu Fenglin, Zhang Qi, Zhou Fazhi, Zheng Chenpeng, Gao Yang, Tang Yi, Chen Jingyu

机构信息

Department of Ultrasound, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.

FUJIFILM Medical System (Guangzhou) Co., Ltd., Guangzhou 510620, China.

出版信息

Diagnostics (Basel). 2023 Oct 17;13(20):3229. doi: 10.3390/diagnostics13203229.

DOI:10.3390/diagnostics13203229
PMID:37892048
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10606135/
Abstract

Cholestatic liver disease is a common liver disease in infants and young children. Liver fibrosis is a key factor affecting the prognosis, and liver transplantation is the only treatment option for liver cirrhosis. This study aimed to explore the efficacy of Combi-elasto for diagnosing liver fibrosis in children affected by cholestatic liver disease. A total of 64 children with S1-S4-grade liver fibrosis were enrolled. The general data, routine ultrasound, Combi-elasto, aspartate aminotransferase-to-platelet ratio index (APRI) and Fibrosis-4 (FIB-4) score were compared among children with different grades of liver fibrosis, and the efficacy of the above indexes for evaluating the degree of liver fibrosis was reported. There were remarkable differences in liver size, liver echogenicity, Young's modulus (E), fibrosis index (FI), activity index (AI) and FIB-4 score among the groups (all < 0.05). E and liver echogenicity were the independent impact factors of liver fibrosis. The areas under the curve of E, APRI, FIB-4 score and the combined model (E+ liver echogenicity) in the evaluation of liver fibrosis were 0.84, 0.61, 0.66 and 0.90, respectively. Ultimately, we concluded that CE is an effective method to evaluate liver fibrosis in children with cholestatic liver disease.

摘要

胆汁淤积性肝病是婴幼儿常见的肝脏疾病。肝纤维化是影响预后的关键因素，肝移植是肝硬化唯一的治疗选择。本研究旨在探讨联合弹性成像（Combi-elasto）对胆汁淤积性肝病患儿肝纤维化的诊断效能。共纳入64例S1-S4级肝纤维化患儿。比较不同肝纤维化分级患儿的一般资料、常规超声、联合弹性成像、天冬氨酸氨基转移酶与血小板比值指数（APRI）及纤维化-4（FIB-4）评分，并报道上述指标评估肝纤维化程度的效能。各组间肝脏大小、肝脏回声、杨氏模量（E）、纤维化指数（FI）、活动指数（AI）及FIB-4评分差异均有统计学意义（均P<0.05）。E及肝脏回声是肝纤维化的独立影响因素。E、APRI、FIB-4评分及联合模型（E+肝脏回声）评估肝纤维化的曲线下面积分别为0.84、0.61、0.66及0.90。最终，我们得出结论，联合弹性成像（CE）是评估胆汁淤积性肝病患儿肝纤维化的有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae68/10606135/66f58af9c162/diagnostics-13-03229-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae68/10606135/0229b500ec7b/diagnostics-13-03229-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae68/10606135/02a26fa6aebd/diagnostics-13-03229-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae68/10606135/b9a353ab8e7f/diagnostics-13-03229-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae68/10606135/15934ca0c233/diagnostics-13-03229-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae68/10606135/b48997df975d/diagnostics-13-03229-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae68/10606135/66f58af9c162/diagnostics-13-03229-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae68/10606135/0229b500ec7b/diagnostics-13-03229-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae68/10606135/02a26fa6aebd/diagnostics-13-03229-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae68/10606135/b9a353ab8e7f/diagnostics-13-03229-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae68/10606135/15934ca0c233/diagnostics-13-03229-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae68/10606135/b48997df975d/diagnostics-13-03229-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae68/10606135/66f58af9c162/diagnostics-13-03229-g006.jpg

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Estimation of liver fibrosis using elastography in cholestatic diseases: systematic review and meta-analysis.
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Diagnostic accuracy of magnetic resonance elastography and point-shear wave elastography for significant hepatic fibrosis screening: Systematic review and meta-analysis.磁共振弹性成像和剪切波弹性成像对显著肝纤维化筛查的诊断准确性：系统评价和荟萃分析。
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