AbiMansour Jad, Chin Jerry Yung-Lun, Kaur Jyotroop, Vargas Eric J, Abu Dayyeh Barham K, Law Ryan, Garimella Vishal, Levy Michael J, Storm Andrew C, Dierkhising Ross, Allen Alina, Venkatesh Sudhakar, Chandrasekhara Vinay
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Department of Internal Medicine.
Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics.
J Clin Gastroenterol. 2025 Mar 1;59(3):256-261. doi: 10.1097/MCG.0000000000002013.
Endoscopic ultrasound shear wave elastography (EUS-SWE) is a novel modality for liver stiffness measurement. The aims of this study are to evaluate the performance and reliability of EUS-SWE for detecting advanced liver disease in a prospective cohort.
EUS-SWE measurements were prospectively obtained from patients undergoing EUS between August 2020 and March 2023. Liver stiffness measurements were compared between patients with and without advanced liver disease (ALD), defined as stage ≥3, to determine diagnostic accuracy for advanced fibrosis and portal hypertension. Logistic regression was performed to identify variables that impact the reliability of EUS-SWE readings. Select patients underwent paired magnetic resonance elastography (MRE) for liver fibrosis correlation.
Patients with ALD demonstrated higher liver stiffness compared to healthy controls (left lobe: 17.6 vs. 12.7 kPa, P <0.001; median right lobe: 24.8 vs. 11.0 kPa, P <0.001). The area under the receiver operator characteristic (AUROC) for the detection of ALD was 0.73 and 0.80 for left and right lobe measurements, respectively. General anesthesia was associated with reliable EUS-SWE liver readings (odds ratio: 2.73, 95% CI: 1.07-7.39, P =0.040). Left lobe measurements correlated significantly with MRE with an increase of 0.11 kPa (95% CI: 0.05-0.17 kPA) for every 1 kPa increase on EUS-SWE. D.
SWE is a promising technology that can readily be incorporated into standard EUS examinations for the assessment of ALD.
内镜超声剪切波弹性成像（EUS-SWE）是一种用于测量肝脏硬度的新型技术。本研究旨在评估EUS-SWE在一个前瞻性队列中检测晚期肝病的性能和可靠性。
前瞻性地获取了2020年8月至2023年3月期间接受EUS检查的患者的EUS-SWE测量值。比较了有和没有晚期肝病（定义为≥3期）的患者的肝脏硬度测量值，以确定对晚期纤维化和门静脉高压的诊断准确性。进行逻辑回归以识别影响EUS-SWE读数可靠性的变量。选择部分患者进行配对磁共振弹性成像（MRE）以进行肝纤维化相关性研究。
与健康对照相比，晚期肝病患者的肝脏硬度更高（左叶：17.6对12.7 kPa，P<0.001；右叶中位数：24.8对11.0 kPa，P<0.001）。检测晚期肝病时，左叶和右叶测量的受试者操作特征曲线下面积（AUROC）分别为0.73和0.80。全身麻醉与可靠的EUS-SWE肝脏读数相关（优势比：2.73，95%CI：1.07-7.39，P=0.040）。左叶测量值与MRE显著相关，EUS-SWE每增加1 kPa，MRE增加0.11 kPa（95%CI：0.05-0.17 kPA）。
SWE是一项有前景的技术，可轻松纳入标准EUS检查以评估晚期肝病。
