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瞬时弹性成像和剪切波弹性成像在 MAFLD 患者中的比较:单中心经验。

Comparison of transient elastography and shear wave elastography in patients with MAFLD: A single-center experience.

机构信息

1Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt.

2Radiology Department, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt.

出版信息

Rom J Intern Med. 2024 Apr 24;62(3):331-340. doi: 10.2478/rjim-2024-0019. Print 2024 Sep 1.

Abstract

BACKGROUND

Metabolic-associated fatty liver disease and liver fibrosis are intimately linked to insulin resistance, type 2 diabetes, obesity, and metabolic syndrome. Transient elastography (TE) and point shear wave elastography (pSWE) were used to measure liver stiffness in patients who met the ultrasound criteria for steatotic liver diseases (SLD). This study compared two methods for estimating liver stiffness in patients with SLD, which in turn correlated with liver fibrosis.

METHOD

Ultrasound B-mode imaging was used to identify SLD. In total, 250 MAFLD patients were recruited. Patient characteristics, laboratory investigations, and liver stiffness measurements using TE and pSWE were assessed on the same day.

RESULTS

In the study, 56.0% of the patients were male, with a mean age of 41.5 ± 10.7 years. The correlation between TE and pSWE was significant (Spearman's r = 0.867*, p < 0.001). The Bland-Altman Plot analysis confirmed this, with 97.5% of variations in LSM falling within 95% agreement ranges. Cohen's κ was used to assess the agreement between TE and pSWE fibrosis stages, showing almost perfect agreement (83.5% kappa agreement) and a strong association between pSWE and TE in the assessment fibrosis stages.

CONCLUSION

In patients with MAFLD, TE, and SWE are reliable methods for measuring liver stiffness and can be used as non-invasive screening tools for the assessment of fibrosis in SLD.

摘要

背景

代谢相关脂肪性肝病和肝纤维化与胰岛素抵抗、2 型糖尿病、肥胖和代谢综合征密切相关。瞬时弹性成像(TE)和点剪切波弹性成像(pSWE)用于测量符合超声脂肪性肝病(SLD)标准的患者的肝硬度。本研究比较了两种方法来评估 SLD 患者的肝硬度,这与肝纤维化相关。

方法

采用超声 B 型成像来识别 SLD。共招募了 250 名 MAFLD 患者。同日评估了患者的特征、实验室检查和使用 TE 和 pSWE 进行的肝硬度测量。

结果

在这项研究中,56.0%的患者为男性,平均年龄为 41.5±10.7 岁。TE 和 pSWE 之间存在显著相关性(Spearman's r=0.867*,p<0.001)。Bland-Altman 图分析证实了这一点,97.5%的 LSM 变化落在 95%一致性范围内。采用 Cohen's κ 评估 TE 和 pSWE 纤维化分期之间的一致性,显示出几乎完美的一致性(83.5%κ一致性)和 pSWE 和 TE 在评估纤维化分期之间的强烈关联。

结论

在 MAFLD 患者中,TE 和 SWE 是测量肝硬度的可靠方法,可作为 SLD 纤维化评估的非侵入性筛查工具。

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