Preoperative noninvasive assessment for liver fibrosis in hepatocellular carcinoma patients with chronic hepatitis B: Comparison of two-dimensional shear-wave elastography with serum liver fibrosis models
Preoperative noninvasive assessment for liver fibrosis in hepatocellular carcinoma patients with chronic hepatitis B: Comparison of two-dimensional shear-wave elastography with serum liver fibrosis models
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DOI：
10.1016/j.ejrad.2020.109386
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发表时间：
2020-12-01
影响因子：
3.3
通讯作者：
Jiang, Tian'an
中科院分区：
文献类型：
--
作者：
Chen, Shuochun;Jiang, Tian'an
目的：探讨二维剪切波弹性成像(2D-SWE)对肝切除术后慢性乙型病毒性肝炎患者的诊断价值，并与血清肝纤维化模型进行比较。方法：对100例首次诊断为肝细胞癌的慢性乙型病毒性肝炎患者在肝切除术前行2D-SWE检查。结果：2D-SWE、Forns评分、天冬氨酸氨基转移酶/血小板比指数和纤维化4分的ROC下面积分别为0.983、0.757、0.745、0.710(F&gT；2)和0.896、0.718、0.626、0.575。2DSWE诊断显著纤维化和肝硬变的AUC显著高于血清纤维化模型(p<；0.05)。在诊断显著纤维化(F>；2)时，Forns的AUC与APRI和FIB-4的AUC无统计学差异(p>；0.05)，而在诊断肝硬变(F=4)时，Forns的AUC显著升高(p<；0.05)。结论：2D-SWE是一种可靠的无创评估肝纤维化的方法，其诊断准确率明显高于血清肝纤维化模型。
Purpose: To investigate the diagnostic performance of two-dimensional shear-wave elastography (2D-SWE) in hepatocellular carcinoma patients with chronic hepatitis B adapted to hepatectomy comparing to serum liver fibrosis models.Method: 100 patients with chronic hepatitis B who first diagnosed with hepatocellular carcinoma and had undergone 2D-SWE measurements before the hepatectomy were included. The performance of 2D-SWE and serum models in the diagnosis of liver fibrosis was assessed using receiver operating characteristic (ROC) analyses.Results: The areas under ROC (AUCs) for 2D-SWE, Forns score, aspartate transaminase-to-platelet ratio index (APRI) and Fibrosis 4 Score (FIB-4) were 0.983, 0.757, 0.745, 0.710 in the diagnosis of significant fibrosis (F > 2) respectively, and 0.896, 0.718, 0.626, 0.575 in the diagnosis of cirrhosis (F = 4) respectively. The AUCs for 2DSWE in the diagnosis of significant fibrosis and cirrhosis were significantly higher than those for the serum fibrosis models (p < 0.05). The AUCs of Forns in the diagnosis of significant fibrosis (F > 2) showed no statistical differences (p > 0.05) with those of APRI and FIB-4 while in the diagnosis of cirrhosis (F = 4), they are significantly higher (p < 0.05).Conclusions: 2D-SWE is a reliable method for preoperative noninvasive assessment of liver fibrosis in HCC patients with CHB, with notably higher diagnostic accuracy than serum liver fibrosis models.