Magnetic resonance elastography plus Fibrosis-4 versus FibroScan-aspartate aminotransferase in detection of candidates for pharmacological treatment of NASH-related fibrosis.
Magnetic resonance elastography plus Fibrosis-4 versus FibroScan-aspartate aminotransferase in detection of candidates for pharmacological treatment of NASH-related fibrosis.
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DOI：
10.1002/hep.32145
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发表时间：
2022-03
期刊：
影响因子：
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中科院分区：
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患有显着肝纤维化（≥2 期）的 NAFLD 患者发生肝脏相关发病的风险增加，是药物治疗的候选者。在本研究中，我们比较了 MEFIB（磁共振弹性成像 [MRE] 和 Fibrosis-4 [FIB-4] 的组合）和 FAST（FibroScan-天冬氨酸转氨酶；通过振动控制瞬时弹性成像、受控衰减参数和天冬氨酸转氨酶组合肝脏硬度测量）检测显着纤维化的诊断准确性。这项前瞻性队列研究包括 234 名连续接受肝活检、MRE 和 FibroScan 的 NAFLD 患者，这些患者在加州大学圣地亚哥分校（UCSD 队列）和日本横滨市立大学的独立队列（N = 314）中进行。主要结局是显着纤维化（≥2 期）的诊断准确性。 UCSD 和横滨队列中显着纤维化的比例分别为 29.5% 和 66.2%。在 UCSD 队列中，MEFIB 的受试者工作特征曲线下面积 (95% CI) (0.860 [0.81–0.91]) 显着高于 FAST (0.757 [0.69–0.82]) (p = 0.005)，与横滨队列中的结果一致 (AUROC，0.899 [MEFIB] 与 0.724 [FAST]；p < 0.001）。当用作入组标准时（MEFIB、MRE ≥ 3.3 kPa 和 FIB-4 ≥ 1.6；FAST ≥ 0.67），显着纤维化的阳性预测值为 MEFIB 的 91.2%–96.0%，FAST 的 74.2%–89.2%。当用作排除标准（MEFIB、MRE < 3.3 kPa 和 FIB-4 < 1.6；FAST ≤ 0.35）时，显着纤维化的阴性预测值为 MEFIB 的 85.6%–92.8% 和 FAST 的 57.8%–88.3%。对于 NAFLD 中的显着纤维化，MEFIB 的诊断准确性比 FAST 更高，我们的结果支持使用两步策略来检测 NAFLD 中的显着纤维化。
Patients with NAFLD with significant hepatic fibrosis (Stage ≥ 2) are at increased risk of liver-related morbidity and are candidates for pharmacologic therapies. In this study, we compared the diagnostic accuracy of MEFIB (the combination of magnetic resonance elastography [MRE] and Fibrosis-4 [FIB-4]) and FAST (FibroScan–aspartate aminotransferase; combined liver stiffness measurement by vibration-controlled transient elastography, controlled attenuation parameter, and aspartate aminotransferase) for detecting significant fibrosis. This prospective cohort study included 234 consecutive patients with NAFLD who underwent liver biopsy, MRE, and FibroScan at the University of California San Diego (UCSD cohort) and an independent cohort (N = 314) from Yokohama City University, Japan. The primary outcome was diagnostic accuracy for significant fibrosis (Stage ≥ 2). The proportions of significant fibrosis in the UCSD and Yokohama cohorts were 29.5% and 66.2%, respectively. Area under the receiver operating characteristic curve (95% CI) of MEFIB (0.860 [0.81–0.91]) was significantly higher than that of FAST (0.757 [0.69–0.82]) in the UCSD cohort (p = 0.005), with consistent results in the Yokohama cohort (AUROC, 0.899 [MEFIB] versus 0.724 [FAST]; p < 0.001). When used as the rule-in criteria (MEFIB, MRE ≥ 3.3 kPa and FIB-4 ≥ 1.6; FAST ≥ 0.67), the positive predictive value for significant fibrosis was 91.2%–96.0% for MEFIB and 74.2%–89.2% for FAST. When used as the rule-out criteria (MEFIB, MRE < 3.3 kPa and FIB-4 < 1.6; FAST ≤ 0.35), the negative predictive value for significant fibrosis was 85.6%–92.8% for MEFIB and 57.8%–88.3% for FAST. MEFIB has higher diagnostic accuracy than FAST for significant fibrosis in NAFLD, and our results support the utility of a two-step strategy for detecting significant fibrosis in NAFLD.
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影响因子：
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作者：
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通讯作者：
Kanda Y
DOI：
10.1038/nrgastro.2018.10
发表时间：
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期刊：
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影响因子：
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DOI：
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发表时间：
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DOI：
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发表时间：
2009-10
期刊：
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
影响因子：
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作者：
Shah AG;Lydecker A;Murray K;Tetri BN;Contos MJ;Sanyal AJ;Nash Clinical Research Network
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Nash Clinical Research Network