Xu Xiangyi, Zhang Yiqing, Zhu Qiwei, Xie Yuchen, Zhou Yuanyuan, Dong Bingtian, Zhang Chaoxue
Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Biomol Biomed. 2025 Mar 7;25(4):810-821. doi: 10.17305/bb.2024.11577.
To assess the diagnostic accuracy of two-dimensional shear wave elastography (2-D SWE) and point shear wave elastography (pSWE) in detecting liver fibrosis stages in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), a comprehensive search was conducted across four databases up to February 9, 2024. A bivariate random-effects model was used to analyze the diagnostic accuracy of the methods. After screening, 13 studies involving pSWE included 1527 patients, while nine studies involving 2-D SWE included 1088 patients. The areas under the summary receiver operating characteristic (SROC) curves for diagnosing significant fibrosis (F ≥ 2), advanced fibrosis (F ≥ 3), and cirrhosis (F = 4) using pSWE and 2-D SWE were as follows: 0.84 (95% CI 0.80-0.87), 0.91 (95% CI 0.88-0.93), and 0.94 (95% CI 0.91-0.95) for pSWE; 0.83 (95% CI 0.79-0.86) 0.85 (95% CI 0.82-0.88), and 0.89 (95% CI 0.86-0.91) for 2-D SWE, respectively. The pooled sensitivity for pSWE and 2-D SWE for stages F ≥ 2, F ≥ 3, and F = 4 were 0.71 (95% CI 0.63-0.78), 0.81 (95% CI 0.72-0.88), and 0.81 (95% CI 0.63-0.91) for pSWE, and 0.77 (95% CI 0.68-0.84), 0.80 (95% CI 0.72-0.87), and 0.92 (95% CI 0.75-0.98) for 2-D SWE, respectively. The pooled specificity of pSWE and 2-D SWE for these stages were 0.83 (95% CI 0.76-0.88), 0.87 (95% Cl: 0.81-0.92), and 0.91 (95% CI 0.86-0.94) for pSWE, and 0.76 (95% CI 0.66-0.84), 0.76 (95% CI 0.69-0.82), and 0.83 (95% CI 0.78-0.85) for 2-D SWE, respectively. In conclusion, both 2-D SWE and pSWE demonstrated high diagnostic performance in identifying various stages of liver fibrosis in MASLD patients.
为评估二维剪切波弹性成像（2-D SWE）和点剪切波弹性成像（pSWE）在检测代谢功能障碍相关脂肪性肝病（MASLD）患者肝纤维化分期中的诊断准确性，截至2024年2月9日，我们在四个数据库中进行了全面检索。采用双变量随机效应模型分析这些方法的诊断准确性。筛选后，13项涉及pSWE的研究纳入了1527例患者，而9项涉及2-D SWE的研究纳入了1088例患者。使用pSWE和2-D SWE诊断显著纤维化（F≥2）、进展性纤维化（F≥3）和肝硬化（F = 4）时，汇总受试者工作特征（SROC）曲线下面积如下：pSWE诊断显著纤维化、进展性纤维化和肝硬化时的曲线下面积分别为0.84（95%CI 0.80 - 0.87）、0.91（95%CI 0.88 - 0.93）和0.94（95%CI 0.91 - 0.95）；2-D SWE诊断显著纤维化、进展性纤维化和肝硬化时的曲线下面积分别为0.83（95%CI 0.79 - 0.86）、0.85（95%CI 0.82 - 0.88）和0.89（95%CI 0.86 - 0.91）。pSWE和2-D SWE诊断F≥2、F≥3和F = 4期的汇总敏感度分别为：pSWE诊断F≥2期为0.71（95%CI 0.63 - 0.78），F≥3期为0.81（95%CI 0.72 - 0.88），F = 4期为0.81（95%CI 0.63 - 0.91）；2-D SWE诊断F≥2期为0.77（95%CI 0.68 - 0.84），F≥3期为0.80（95%CI 0.72 - 0.87），F = 4期为0.92（95%CI 0.75 - 0.98）。pSWE和2-D SWE在这些分期中的汇总特异度分别为：pSWE诊断F≥2期为0.83（95%CI 0.76 - 0.88），F≥3期为0.87（95%CI 0.81 - 0.92），F = 4期为0.91（95%CI 0.86 - 0.94）；2-D SWE诊断F≥2期为0.76（95%CI 0.66 - 0.84），F≥3期为0.76（95%CI 0.69 - 0.82），F = 4期为0.83（95%CI 0.78 - 0.85）。总之，2-D SWE和pSWE在识别MASLD患者肝纤维化的各个分期中均表现出较高的诊断性能。
