Assessment of impact factors on shear wave based liver stiffness measurement
Assessment of impact factors on shear wave based liver stiffness measurement
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基于剪切波的肝脏硬度测量的影响因素评估
DOI：
10.1016/j.ejrad.2012.10.004
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发表时间：
2013-02-01
影响因子：
3.3
通讯作者：
Luo, Yan
中科院分区：
文献类型：
--
作者：
Ling, Wenwu;Lu, Qiang;Luo, Yan
基于剪切波的超声弹性成像已成为定量评估肝脏硬度的无创方法。然而，只有少数研究调查了肝脏硬度测量（LSM）的影响因素。此外，临床实践中还缺乏标准的LSM检查方案。我们的研究旨在评估影响LSM的因素，以便在临床实践中建立标准的检查方案。我们在21名健康个体中应用基于剪切波的弹性成像点量化（ElastPQ）来确定肝脏位置（I-VIII节段）、呼吸阶段（吸气末和呼气末）、探头位置（肋下和肋间位置）和检查者对LSM的影响。另外还对175名健康个体进行了研究，以确定性别和年龄对肝脏硬度的影响。我们发现肝脏位置对LSM有显著影响，而肝段V的变异系数最低（CV 21%）。呼气末肝僵硬度显著高于吸气末（P = 2.1E-05）。男性肝脏僵硬度比女性高8% （3.8 +/- 0.7 kPa比3.5 +/- 0.4 kPa, P = 0.0168）。相反，不同探头位置、检查者和年龄组的肝脏硬度具有可比性（P < 0.05）。总之，本研究揭示了肝脏位置、呼吸期和性别对LSM的显著影响，同时进一步加强了制定LSM标准检查方案的必要性。2012爱思唯尔爱尔兰有限公司版权所有。
Shear wave based ultrasound elastographies have been implemented as non-invasive methods for quantitative assessment of liver stiffness. Nonetheless, there are only a few studies that have investigated impact factors on liver stiffness measurement (LSM). Moreover, standard examination protocols for LSM are still lacking in clinical practice. Our study aimed to assess the impact factors on LSM to establish its standard examination protocols in clinical practice. We applied shear wave based elastography point quantification (ElastPQ) in 21 healthy individuals to determine the impact of liver location (segments I-VIII), breathing phase (end-inspiration and end-expiration), probe position (sub-costal and inter-costal position) and examiner on LSM. Additional studies in 175 healthy individuals were also performed to determine the influence of gender and age on liver stiffness. We found significant impact of liver location on LSM, while the liver segment V displayed the lowest coefficient of variation (CV 21%). The liver stiffness at the end-expiration was significantly higher than that at the end-inspiration (P = 2.1E-05). The liver stiffness was 8% higher in men than in women (3.8 +/- 0.7 kPa vs. 3.5 +/- 0.4 kPa, P = 0.0168). In contrast, the liver stiffness was comparable in the different probe positions, examiners and age groups (P > 0.05). In conclusion, this study reveals significant impact from liver location, breathing phase and gender on LSM, while furthermore strengthening the necessity for the development of standard examination protocols on LSM. (C) 2012 Elsevier Ireland Ltd. All rights reserved.