Losurdo Giuseppe, Ditonno Ilaria, Novielli Domenico, Celiberto Francesca, Iannone Andrea, Castellaneta Antonino, Dell'Aquila Paola, Ranaldo Nunzio, Rendina Maria, Barone Michele, Ierardi Enzo, Di Leo Alfredo
Section of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy.
Ph.D. Course in Organs and Tissues Transplantation and Cellular Therapies, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy.
Diagnostics (Basel). 2024 Mar 12;14(6):604. doi: 10.3390/diagnostics14060604.
Liver stiffness measurement (LSM) by Fibroscan is the most used non-invasive method to assess liver fibrosis. Recently, point-shear wave elastography (pSWE) has been introduced as a simple alternative non-invasive test. Therefore, we aimed to compare the results of these two techniques. One hundred and eighty-four consecutive patients attending our outpatient ultrasound clinic were recruited. LSM was performed by both Fibroscan and pSWE. Statistical analysis was conducted by Spearman's test for correlation and linear regression. Bland-Altman graphs and ROC curves were drawn with area under the curve (AUC). Overall, the correlation of LS between Fibroscan and pSWE was substantial (r = 0.68, < 0.001). Linear regression showed a coefficient b= 0.94 ± 0.02. The Bland-Altman plot found a bias of -0.10, with only 11 values exceeding the 95% confidence interval. When only considering patients with a LSM of > 10 kPa ( = 31), we found an excellent r = 0.79 (0.60-0.90, < 0.001). A cutoff of 12.15 kPa for pSWE had sensitivity = 74.2% and specificity = 99.3% to detect relevant fibrosis, with an AUC = 0.98. The highest correlation was observed for hepatitis C (r = 0.91) and alcoholic liver disease (ALD)(r = 0.99). In conclusion, pSWE shows LSM estimation in agreement with Fibroscan in most cases, and the best concordance was observed for hepatitis C and ALD, and for higher ranges of LS.
通过Fibroscan进行肝脏硬度测量(LSM)是评估肝纤维化最常用的非侵入性方法。最近,点剪切波弹性成像(pSWE)作为一种简单的替代性非侵入性检查被引入。因此,我们旨在比较这两种技术的结果。招募了连续184例到我们门诊超声诊所就诊的患者。通过Fibroscan和pSWE进行LSM。采用Spearman相关性检验和线性回归进行统计分析。绘制Bland-Altman图和ROC曲线,并计算曲线下面积(AUC)。总体而言,Fibroscan和pSWE之间的肝脏硬度(LS)相关性很强(r = 0.68,P < 0.001)。线性回归显示系数b = 0.94±0.02。Bland-Altman图显示偏差为-0.10,只有11个值超出95%置信区间。仅考虑LSM>10 kPa的患者(n = 31)时,我们发现相关性极佳,r = 0.79(0.60 - 0.90,P < 0.001)。pSWE的截断值为12.15 kPa时,检测相关纤维化的灵敏度为74.2%,特异性为99.3%,AUC = 0.98。丙型肝炎(r = 0.91)和酒精性肝病(ALD)(r = 0.99)的相关性最高。总之,在大多数情况下,pSWE显示的LSM估计值与Fibroscan一致,丙型肝炎和ALD以及较高LS范围的一致性最佳。