Radiology Department.
Internal Medicine Department.
Ultrasound Q. 2024 Mar 1;40(1):74-81. doi: 10.1097/RUQ.0000000000000677.
Our aim was to predict these stages of hepatic fibrosis and necroinflammation using measurements from two-dimensional shear wave elastography (2D-SWE), transient elastography (Fibroscan, TE), and shear wave dispersion (SWD).
In this prospectively designed study, chronic liver patients with nonspecific etiology whose biopsy was performed for up to 1 week were included. Two-dimensional SWE, SWD, and TE measurements were performed. The METAVIR and F-ISHAK classification was used for histopathological evaluation.
Two-dimensional SWE and TE were considered significant for detecting hepatic fibrosis. In distinguishing ≥F2, for 2D-SWE, area under the receiver operating characteristics (AUROC) was 0.86 (confidence interval [CI], 0.75-0.96) for the cutoff value of 8.05 kPa ( P = 0.003); for TE, AUROC was 0.79 (CI, 0.65-0.94) for the cutoff value of 10.4 kPa ( P < 0.001). No significance was found for TE in distinguishing ≥F3 ( P = 0.132). However, for 2D-SWE, a cutoff value of 10.45 kPa ( P < 0.001), with AUROC = 0.87 (CI, 0.78-0.97) was determined for ≥F3. Shear wave dispersion was able to determine the presence of necroinflammation ( P = 0.016) and a cutoff value of 15.25 (meter/second)/kiloHertz ([m/s]/kHz) ( P = 0.006) and AUROC of 0.71 (CI, 0.57-0.85) were calculated for distinguishing ≥A2. In addition, a cutoff value of 17.25 (m/s)/kHz ( P = 0.023) and AUROC = 0.72 (CI, 0.51-0.93) were found to detect severe necroinflammation. The cutoff value for SWD was 15.25 (m/s)/kHz ( P = 0.013) for detecting ≥A2 in the reversible stage of fibrosis (F0, F1, and F2), and AUROC = 0.72 (CI, 0.56-0.88).
Two-dimensional SWE and TE measurements were significant in detecting the irreversible stage and the stage that should be treated in hepatic fibrosis noninvasively. Shear wave dispersion measurements were significant in detecting necroinflammation noninvasively.
我们旨在使用二维剪切波弹性成像（2D-SWE）、瞬时弹性成像（Fibroscan，TE）和剪切波分散（SWD）的测量值来预测肝纤维化和坏死性炎症的这些阶段。
在这项前瞻性设计的研究中，纳入了因非特异性病因接受肝活检的慢性肝病患者，其活检时间不超过 1 周。进行了二维 SWE、SWD 和 TE 测量。采用 METAVIR 和 F-ISHAK 分类进行组织病理学评估。
二维 SWE 和 TE 被认为可用于检测肝纤维化。在区分≥F2 时，对于 2D-SWE，截断值为 8.05 kPa 时的受试者工作特征曲线（AUROC）为 0.86（置信区间 [CI]，0.75-0.96）（ P = 0.003）；对于 TE，截断值为 10.4 kPa 时的 AUROC 为 0.79（CI，0.65-0.94）（ P < 0.001）。在区分≥F3 时，TE 无统计学意义（ P = 0.132）。然而，对于 2D-SWE，确定截断值为 10.45 kPa（ P < 0.001），AUROC 为 0.87（CI，0.78-0.97），用于≥F3。SWD 可确定坏死性炎症的存在（ P = 0.016），并计算出 15.25（米/秒）/千赫兹（[m/s]/kHz）（ P = 0.006）的截断值和 AUROC 为 0.71（CI，0.57-0.85），用于区分≥A2。此外，发现 17.25（m/s）/kHz（ P = 0.023）的截断值和 AUROC = 0.72（CI，0.51-0.93）用于检测严重坏死性炎症。SWD 的截断值为 15.25（m/s）/kHz（ P = 0.013），用于检测纤维化可逆阶段（F0、F1 和 F2）中的≥A2，AUROC = 0.72（CI，0.56-0.88）。
二维 SWE 和 TE 测量值在检测肝纤维化的不可逆阶段和需要进行治疗的阶段具有重要意义。SWD 测量值在检测坏死性炎症方面具有重要意义。
