Two-dimensional Shear Wave Elastography with Propagation Maps for the Assessment of Liver Fibrosis and Clinically Significant Portal Hypertension in Patients with Chronic Liver Disease: A Prospective Study
Two-dimensional Shear Wave Elastography with Propagation Maps for the Assessment of Liver Fibrosis and Clinically Significant Portal Hypertension in Patients with Chronic Liver Disease: A Prospective Study
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DOI：
10.1016/j.acra.2019.08.006
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发表时间：
2020-06-01
影响因子：
4.8
通讯作者：
Han, Joon Koo
中科院分区：
文献类型：
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作者：
Jeon, Sun Kyung;Lee, Jeong Min;Han, Joon Koo
目的：探讨二维（2D）剪切波弹性成像（SWE）肝硬度（LS）测量的诊断性能，用于评估肝纤维化使用LS测量MR弹性成像（MRE）作为参考标准和临床显着的门脉高压症（CSPH.Methods）的预测：在这项前瞻性研究中，101例慢性肝病或肝硬化患者进行了MRE和SWE。排除MRE技术故障（n = 5）、SWE技术故障/不可靠测量（n = 4）后，借助传播图在SWE上获得的LS测量值使用Pearson相关分析与MRE的测量值相关。结果：SWE与MRE的LS值呈强相关（r = 0.846，P <0.001），SWE的LS值与MRE的LS值呈负相关（r = 0.846，P < 0.001）。对于诊断B型肝炎病毒相关肝病患者（n = 75）的显著纤维化或肝硬化，SWE显示ROC曲线下面积（AUC）分别为0.975和0.912（95%置信区间[CI]，0.910-997和0.824-0.965）。对于CSPH的预测，SWE的AUC为0.818（95%CI，0.712-0.898），当LS值为11.5 kPa作为临界值时，SWE的敏感性为81.5%，特异性为72.9%。2D SWE上的LS测量结果与MRE获得的结果具有良好的相关性，因此，可以为预测肝纤维化和CSPH的存在提供良好的诊断性能。
Objectives: To investigate the diagnostic performance of liver stiffness (LS) measurements on two-dimensional (2D) shear wave elastography (SWE) for the assessment of hepatic fibrosis using LS measurements on MR elastography (MRE) as the reference standard and the prediction of clinically significant portal hypertension (CSPH).Methods: In this prospective study, 101 patients with chronic liver disease or cirrhosis underwent both MRE and SWE. After exclusion of technical failure on MRE (n = 5), technical failure/unreliable measurement on SWE (n = 4), LS measurements obtained on SWE with the aid of propagation maps were correlated with those of the MRE using Pearson's correlation analysis. Diagnostic performances for significant fibrosis (>= F2: MRE of >= 2.99 kPa) or cirrhosis (F4: MRE of >= 3.63 kPa) and for the prediction of CSPH were assessed using receiver operating characteristics (ROC) curve analysis.Results: LS values on SWE showed a strong correlation with those on MRE (r = 0.846, P < 0.001). For the diagnosis of significant fibrosis or cirrhosis in patients with hepatitis B virus-related liver disease (n = 75), SWE showed areas under the ROC curves (AUC) of 0.975 and 0.912, respectively (95% confidence interval [CI], 0.910-997, and 0.824-0.965). For the prediction of CSPH, the AUC of SWE was 0.818 (95% CI, 0.712-0.898), and when an LS value of 11.5 kPa was applied as a cut-off, SWE showed a sensitivity of 81.5% and a specificity of 72.9%.Conclusion: LS measurements on 2D SWE were demonstrated to be well correlated with those obtained with MRE, and thus, may provide good diagnostic performance for the prediction of hepatic fibrosis and the presence of CSPH.