Acoustic radiation force impulse-imaging and transient elastography for non-invasive assessment of liver fibrosis and steatosis in NAFLD
Acoustic radiation force impulse-imaging and transient elastography for non-invasive assessment of liver fibrosis and steatosis in NAFLD
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DOI：
10.1016/j.ejrad.2011.10.029
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发表时间：
2012-03-01
影响因子：
3.3
通讯作者：
Bojunga, Joerg
中科院分区：
文献类型：
--
作者：
Friedrich-Rust, Mireen;Romen, Daniela;Bojunga, Joerg
背景资料：瞬态弹性成像（TE）和声辐射力脉冲（ARFI）成像显示出有前途的结果肝fibrosis.Aim的分期：本研究的目的是比较ARFI的左，右肝叶TE使用标准和肥胖探头诊断NAFL/NASH肝纤维化。此外，还使用新型控制衰减参数（CAP）评估肝脏脂肪变性。方法：61例NAFLD/NASH患者纳入本研究。所有患者均接受了两种探头的TE、两个肝叶的ARFI和CAP。结果：57例患者均进入结果分析。M-和XL-探头TE测量和左右肝叶ARFI诊断严重肝纤维化的准确度分别为0.73、0.84、0.71和0.60，诊断肝硬化的准确度分别为0.93、0.93、0.74和0.90。当考虑到两种方法的最佳结果时，在TE测量可靠的患者亚组中，TE和ARFI之间的结果无显著差异。然而，虽然TE与组织学肝纤维化有显著相关性，但ARFI与肝纤维化的相关性无统计学意义。CAP与组织学脂肪变性有显著相关性（r = 0.49，p < 0.001）。结论：瞬时弹性成像和ARFI对肝纤维化的诊断准确性无显著差异。然而，TE与肝纤维化显著相关，而ARFI则不相关。CAP可以对脂肪变性进行非侵入性评估。(C)2011爱思唯尔爱尔兰有限公司保留所有权利。
Background: Transient elastography (TE) and acoustic radiation force impulse (ARFI)-imaging have shown promising results for the staging of liver fibrosis.Aim: The aim of the present study was to compare ARFI of the left and right liver lobe with TE using the standard and obese probes for the diagnosis of liver fibrosis in NAFL/NASH. In addition, liver steatosis is evaluated using the novel controlled attenuation parameter (CAP).Methods: Sixty-one patients with NAFLD/NASH were included in the study. All patients received TE with both probes, ARFI of both liver lobes and CAP. The results were compared with liver histology.Results: 57 patients were included in the final analysis. The diagnostic accuracy for TE measurements with the M-and XL-probe and for ARFI of the right and left liver lobe was 0.73, 0.84, 0.71 and 0.60 for the diagnosis of severe fibrosis, and 0.93, 0.93, 0.74 and 0.90 for the diagnosis of cirrhosis, respectively. No significant difference of results was observed between TE and ARFI in the subgroup of patients with reliable TE-measurement when taking into account the best results of both methods. However, while a significant correlation could be found for TE with histological liver fibrosis, the correlation of ARFI with liver fibrosis was not statistically significant. A significant correlation was found for CAP with histological steatosis (r = 0.49, p < 0.001).Conclusions: No significant difference in diagnostic accuracy for the non-invasive assessment of liver fibrosis was found for transient elastography and ARFI. Nevertheless TE significantly correlated with liver fibrosis while ARFI did not. CAP enables the non-invasive assessment of steatosis. (C) 2011 Elsevier Ireland Ltd. All rights reserved.