Assessment of liver fibrosis in chronic hepatitis B using acoustic structure quantification: quantitative morphological ultrasound
Assessment of liver fibrosis in chronic hepatitis B using acoustic structure quantification: quantitative morphological ultrasound
复制标题
使用声结构定量评估慢性乙型肝炎肝纤维化：定量形态学超声
DOI：
10.1007/s00330-015-4056-x
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发表时间：
2016-07-01
影响因子：
5.9
通讯作者：
Wang, Wei
中科院分区：
文献类型：
--
作者：
Huang, Yang;Wang, Zhu;Wang, Wei
ObjectivesTo前瞻性研究声学结构定量（ASQ）对慢性B肝炎（CHB）患者肝纤维化的无创性评估的有效性。ASQ参数，称为局灶性障碍（FD）比，与METAVIR评分进行比较。采用受试者工作特征（ROC）曲线和多元回归分析方法进行分析。显著纤维化（≥ F2）、重度纤维化（≥ F3）和肝硬化（= F4）的FD比率的ROC曲线下面积分别为0.84、0.86和0.83。对于纤维化分期≥ F2、≥ F3和= F4，FD比值的最佳临界值分别为0.25、0.30和0.50。FD比率和组织学分期之间至少有两个分期差异的患病率为12.3%（14/114）。肝纤维化分期（P< 0.001）、脂肪变性程度（P< 0.001）是影响FD比值的独立因素。结论FD比值可作为慢性乙型肝炎患者肝纤维化的一个有效的无创性影像学指标。FD比率在评估肝纤维化方面显示出有希望的诊断准确性。纤维化程度和脂肪变性是影响FD发生率的独立因素。
ObjectivesTo prospectively investigate the usefulness of acoustic structure quantification (ASQ) for noninvasive assessment of liver fibrosis in patients with chronic hepatitis B (CHB).MethodsConsecutive patients with CHB scheduled for liver biopsy or partial liver resection underwent standardized ASQ examinations. The ASQ parameter, named focal disturbance (FD) ratio, were compared with METAVIR scores. The analysis was based on receiver operating characteristic (ROC) curves and multiple regression analysis.ResultsA total of 114 patients were enrolled in the final analysis. The area under the ROC curve for the FD ratio was 0.84 for significant fibrosis (≥ F2), 0.86 for severe fibrosis (≥ F3), and 0.83 for cirrhosis (= F4). The optimal cutoff values for the FD ratio were 0.25, 0.30 and 0.50 for fibrosis stages ≥ F2, ≥ F3 and = F4, respectively. The prevalence of a difference of at least two stages between the FD ratio and the histological stage was 12.3 % (14 of 114). The fibrosis stage (P< 0.001), degree of steatosis (P< 0.001) were independent factors associated with the FD ratio.ConclusionsFD ratio should be an effective noninvasive imaging biomarker for the assessment of liver fibrosis in patients with CHB.Key Points•Focal disturbance (FD) ratio increased with the increasing histological fibrosis stages.•FD ratio showed promising diagnostic accuracy in assessing liver fibrosis.•Degree of fibrosis and steatosis were independent factors associated with FD ratio.