Validation of the FibroScan-aspartate aminotransferase score by vibration-controlled transient and B-mode ultrasound elastography.
Validation of the FibroScan-aspartate aminotransferase score by vibration-controlled transient and B-mode ultrasound elastography.
复制标题
通过振动控制瞬态和 B 型超声弹性成像验证 FibroScan-天冬氨酸转氨酶评分。
DOI：
10.1111/hepr.13646
复制
发表时间：
2021
影响因子：
4.2
通讯作者：
Hiasa Y.
中科院分区：
文献类型：
--
作者：
Hirooka M;Koizumi Y;Yano R;Sunago K;Watanabe T;Yoshida O;Tokumoto Y;Abe M;Hiasa Y.
目的FibroScan-天冬氨酸转氨酶（FAST）评分是一种简单可行的方法，用于识别晚期非酒精性脂肪性肝炎。最近，剪切波弹性成像和B模式超声（US）的衰减系数测量已得到广泛应用。我们研究了使用超声弹性成像计算的FAST评分与使用振动控制瞬态弹性成像（VCTE）计算的FAST评分的诊断准确性。方法回顾性分析了2015年1月至2020年9月期间在同一天接受VCTE、点剪切波弹性成像和衰减系数测量以及肝活检的慢性肝病患者。94例使用M和XL探头进行了VCTE。VCTE（0.846）和US弹性成像（0.814;p= 0.251）以及M（0.857）和XL探头（0.833;p= 0.412）的C统计量相似。散点图和Bland-Altman图显示FAST评分具有良好的重现性。对于VCTE，临界值≤0.35的灵敏度为92.3%，阴性预测值为85.5%，阴性似然比为0.14，临界值≥0.67的特异性为90.6%，阳性预测值为88.1%，阳性似然比为6.03，分别用于排除和治疗晚期非酒精性脂肪性肝炎。对于超声弹性成像，临界值≤0.35的灵敏度为90.4%，阴性预测值为83.3%，阴性似然比为0.16，临界值≥0.67的特异性为91.8%，阳性预测值为85.1%，阳性似然比为4.67，用于排除和治疗晚期非酒精性脂肪性肝炎，结论即使使用不同的超声设备或探头，FAST评分的重复性也很高。
AimThe FibroScan‐aspartate aminotransferase (FAST) score comprises an easy and feasible method for identifying advanced non‐alcoholic steatohepatitis. Recently, shear‐wave elastography and attenuation coefficient measurement on B‐mode ultrasound (US) have become widely utilized. We investigated the diagnostic accuracy of the FAST score as calculated using US‐elastography compared with that using vibration‐controlled transient elastography (VCTE).MethodsPatients with chronic liver disease who underwent VCTE, point‐shear‐wave elastography with attenuation coefficient measurement, and liver biopsy on the same day between January 2015 and September 2020 were retrospectively reviewed.ResultsOf 189 patients, 94 underwent VCTE using both M and XL probes. The C‐statistics were similar for VCTE (0.846) and US‐elastography (0.814;p= 0.251), and for M (0.857) and XL probes (0.833;p= 0.412). Scatter and Bland–Altman plots showed good reproducibility for the FAST score. For VCTE, a cut‐off of ≤0.35 had a sensitivity of 92.3%, negative predictive value of 85.5%, and negative likelihood ratio of 0.14, and a cut‐off of ≥0.67 had a specificity of 90.6%, positive predictive value of 88.1%, and positive likelihood ratio of 6.03, for ruling out and in advanced non‐alcoholic steatohepatitis, respectively. For US‐elastography, a cut‐off of ≤0.35 had a sensitivity of 90.4%, negative predictive value of 83.3%, and negative likelihood ratio of 0.16, and a cutoff of ≥0.67 had a specificity of 91.8%, positive predictive value of 85.1%, and positive likelihood ratio of 4.67, for ruling out and in advanced non‐alcoholic steatohepatitis, respectively.ConclusionsThe FAST score is highly reproducible, even when different echo equipment or probes are used.