Assessment of Liver Fibrosis with Real-Time Tissue Elastography in Chronic Viral Hepatitis
Assessment of Liver Fibrosis with Real-Time Tissue Elastography in Chronic Viral Hepatitis
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DOI：
10.1159/000345884
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发表时间：
2013-01-01
期刊：
影响因子：
3.5
通讯作者：
Kawada, Norifumi
中科院分区：
文献类型：
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作者：
Yada, Norihisa;Kudo, Masatoshi;Kawada, Norifumi
目的：本研究的目的是前瞻性评估实时组织弹性成像（RTE）测量慢性病毒性肝炎患者肝纤维化的准确性。方法：前瞻性纳入245例患者。从应变图像中测量9个图像特征，并根据这些特征计算肝纤维化指数（LFI）。超声引导下活检病理标本诊断纤维化分期。将LFI、血清学指标与病理诊断进行比较，比较RTE的诊断效能。结果：FO、F1、F2、F3、F4期LFI分别为1.58、2.03、2.40、2.86，随着肝纤维化程度的加重，LFI逐渐升高（p < 0.001）。F2期的LFI与F3期的LFI无显著差异，而其他所有分期组合的LFI均有显著差异。LFI、血小板计数、天冬氨酸/丙氨酸氨基转移酶比值、天冬氨酸氨基转移酶/血小板比值、FibroIndex预测F3分期及以上（F0-F2 vs. F3- f4）的受试者工作特征曲线下面积分别为0.865、0.824、0.708、0.789、0.828。结论：RTE可用于诊断慢性病毒性肝炎患者肝纤维化，不论分期。巴塞尔S. Karger股份有限公司版权所有
Objective: The aim of this study was to assess prospectively the accuracy of measurement of liver fibrosis with real-time tissue elastography (RTE) in patients with chronic viral hepatitis. Methods: Two hundred and forty-five patients were prospectively enrolled. Nine image features were measured from strain images, and Liver Fibrosis Index (LFI) was calculated from these features. Fibrosis stage was diagnosed from pathological specimens obtained by ultrasound-guided biopsy. LFI and serological markers were compared with pathological diagnosis, and the diagnostic performance of RTE was compared. Results: LFI in stages FO F1, F2, F3 and F4 was 1.58, 2.03, 2.40 and 2.86, respectively, demonstrating a stepwise increase with increasing severity of liver fibrosis (p < 0.001). LFI in F2 did not significantly differ from that in F3, whereas for all other combinations of stages, there were significant differences. The area under the receiver operating characteristic curve of the LFI, platelet count, aspartate/alanine anninotransferase ratio, aspartate aminotransferase-to-platelet ratio, and FibroIndex for predicting F3 stage or higher (F0-F2 vs. F3-F4) was 0.865, 0.824, 0.708, 0.789 and 0.828, respectively. Conclusions: RTE is useful for diagnosis of liver fibrosis, regardless of stage, in patients with chronic viral hepatitis. Copyright (C) 2013 S. Karger AG, Basel