How useful are ARFI elastography cut-off values proposed by meta-analysis for predicting the significant fibrosis and compensated liver cirrhosis?
How useful are ARFI elastography cut-off values proposed by meta-analysis for predicting the significant fibrosis and compensated liver cirrhosis?
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DOI：
10.11152/mu.2013.2066.172.arfi
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发表时间：
2015-06-01
影响因子：
1.7
通讯作者：
Gradinaru-Tascau, Oana
中科院分区：
文献类型：
--
作者：
Bota, Simona;Sporea, Ioan;Gradinaru-Tascau, Oana
目的：通过使用荟萃分析提出的声辐射力脉冲（ARFI）弹性成像截止值，评估我们“错过”至少有显著纤维化（F >= 2）的慢性丙型肝炎患者和代偿性肝硬化患者的频率。材料和方法：我们的研究包括132例慢性丙型肝炎患者，通过ARFI和肝活检（LB），在同一时间进行评估。可靠的测量值定义为：成功率>= 60%的10个肝硬度（LS）测量值的中位数，四分位数间距= 2，F=4，我们使用最新发表的荟萃分析中提出的LS截止值：分别为1.35 m/s和1.87 m/s。结果：117例（87.9%）患者通过ARFI获得了可靠的LS测量值。在我们的研究中，58例患者（49.6%）在LB中LS值= 2。在LS值>= 1.35 m/s的59例患者（50.4%）中，仅6.8%的患者在LB中具有F0或F1。此外，在我们的研究中，88例患者（75.3%）的LS值= 1.87 m/s，41.3%的LB中有F4。在单变量和多变量分析中，无论是预测至少显著的纤维化还是肝硬化，较高的转氨酶水平都与错误分类的患者相关。结论：ARFI弹性成像对于预测显著纤维化的存在具有非常好的阳性预测值（93.2%），对于排除代偿性肝硬化的存在具有极好的阴性预测值（97.8%）。
Aim: To evaluate how often do we "miss" chronic hepatitis C patients with at least significant fibrosis (F >= 2) and those with compensated cirrhosis, by using Acoustic Radiation Force Impulse (ARFI) elastography cut-off values proposed by meta-analysis. Material and methods: Our study included 132 patients with chronic hepatitis C, evaluated by means of ARFI and liver biopsy (LB), in the same session. Reliable measurements were defined as: median value of 10 liver stiffness (LS) measurements with a success rate >= 60% and an interquartile range interval= 2 and F=4 we used the LS cut-offs proposed in the last published meta-analysis: 1.35 m/s and 1.87 m/s, respectively. Results: Reliable LS measurements by means of ARFI were obtained in 117 patients (87.9%). In our study, 58 patients (49.6%) had LS values = 2 in LB. From the 59 patients (50.4%) with LS values >= 1.35 m/s, only 6.8% had F0 or F1 in LB. Also, in our study, 88 patients (75.3%) had LS values = 1.87 m/s, 41.3% had F4 in LB. Both for prediction of at least significant fibrosis and liver cirrhosis, higher aminotransferases levels were associated with wrongly classified patients, in univariate and multivariate analysis. Conclusions: ARFI elastography had a very good positive predictive value (93.2%) for predicting the presence of significant fibrosis and excellent negative predictive value (97.8%) for excluding the presence of compensated liver cirrhosis.