Real-time elastography for noninvasive assessment of liver fibrosis in chronic viral hepatitis
Real-time elastography for noninvasive assessment of liver fibrosis in chronic viral hepatitis
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DOI：
10.2214/ajr.06.0322
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发表时间：
2007-03-01
影响因子：
5
通讯作者：
Sarrazin, Christoph
中科院分区：
文献类型：
--
作者：
Friedrich-Rust, Mireen;Ong, Mei-Fang;Sarrazin, Christoph
OBJECTIVE.最近，瞬时弹性成像（FibroScan）已被引入用于肝纤维化的非侵入性分期。在这里，我们研究了一种使用基于超声的实时弹性成像非侵入性评估肝纤维化的新方法，该方法可以在常规超声检查期间使用传统超声探头进行。材料和方法。对79例慢性病毒性肝炎和已知纤维化分期的患者和20例健康志愿者进行实时弹性成像。一个专门开发的程序被用于量化的组织弹性。进行逐步逻辑回归分析，以确定弹性评分，使用的变量具有较高的重现性，在前面的分析数据，从16个不同的患者。此外，分析中还包括天冬氨酸转氨酶与血小板比率指数（APRI）和常规实验室检查值。使用实时弹性成像获得的弹性评分与组织学纤维化分期之间的斯皮尔曼相关系数为0.48，具有高度显著性（p < 0.001）。以受试者工作特征（ROC）曲线下面积表示的诊断准确度对于显著纤维化（根据METAVIR评分系统的纤维化分期[F] >= F2）的诊断为0.75，对于严重纤维化（F >= F3）为0.73，对于肝硬化为0.69。对于弹性-实验室综合评分，ROC曲线下面积分别为0.93、0.95和0.91。实时弹性成像是一种新的和有前途的超声为基础的非侵入性方法评估慢性病毒性肝炎患者的肝纤维化。
OBJECTIVE. Recently, transient elastography (FibroScan) has been introduced for noninvasive staging of liver fibrosis. Here, we investigated a novel approach for noninvasive assessment of liver fibrosis using sonography-based real-time elastography, which can be performed with conventional ultrasound probes during a routine sonography examination.MATERIALS AND METHODS. Real-time elastography was performed in 79 patients with chronic viral hepatitis and known fibrosis stage and in 20 healthy volunteers. A specially developed program was used for quantification of tissue elasticity. Stepwise logistic regression analysis was performed to define an elasticity score using variables with high reproducibility in a preceding analysis of data from 16 different patients. In addition, aspartate transaminase-to-platelet ratio index (APRI) and routine laboratory values were included in the analysis.RESULTS. The Spearman's correlation coefficient between the elasticity scores obtained using real-time elastography and the histologic fibrosis stage was 0.48, which is highly significant (p < 0.001). The diagnostic accuracy expressed as areas under receiver operating characteristic (ROC) curves were 0.75 for the diagnosis of significant fibrosis (fibrosis stage according to METAVIR scoring system [F] >= F2), 0.73 for severe fibrosis (F >= F3), and 0.69 for cirrhosis. For a combined elasticity-laboratory score, the areas under the ROC curves were 0.93, 0.95, and 0.91, respectively.DISCUSSION. Real-time elastography is a new and promising sonography-based noninvasive method for the assessment of liver fibrosis in patients with chronic viral hepatitis.