Real-time tissue elastography as a tool for the noninvasive assessment of liver stiffness in patients with chronic hepatitis C
Real-time tissue elastography as a tool for the noninvasive assessment of liver stiffness in patients with chronic hepatitis C
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DOI：
10.1007/s00535-010-0301-x
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发表时间：
2011-03-01
影响因子：
6.3
通讯作者：
Kawada, Norifumi
中科院分区：
文献类型：
--
作者：
Morikawa, Hiroyasu;Fukuda, Katsuhiko;Kawada, Norifumi
虽然通过“侵入性”肝活检进行的组织病理学检查仍然是评估慢性肝病疾病进展的金标准，但非侵入性工具已经出现，并在诊断肝纤维化阶段方面取得了很大进展。为评价实时组织弹性成像（real-time tissue elastography，RTE）和瞬时弹性成像（transient elastography，Fibroscan）在肝脏弹性测量中的应用价值，对101例慢性丙型肝炎患者进行了实时组织弹性成像（Real-time tissue elastography，RTE）、瞬时弹性成像（transient elastography，Fibroscan）、肝活检和常规实验室检查。将使用连接到RTE的新型软件（Elasto_ver 1.5.1）获得的组织弹性值转换为四个图像特征：平均值、标准差（SD）、面积和复杂度。分析了它们与活检时纤维化分期和Fibroscan获得的肝脏硬度（kPa）的关系。通过RTE获得的彩色图像分为弥漫性软、中间和斑片状硬模式，根据纤维化分期计算的弹性在患者之间存在显著差异（p < 0.0001），并与纤维化分期相关（p < 0.0001）。平均值、SD、面积和复杂度显示纤维化阶段之间的显著差异（Tukey-Kramer检验，p < 0.05）。在区分肝硬化患者时，平均值的受试者工作特征曲线（AUC）下的面积为0.91，SD为0.84，面积为0.91，复杂度为0.93，Fibroscan为0.95。
Although histopathological examination by "invasive" liver biopsy remains the gold standard for evaluating disease progression in chronic liver disease, noninvasive tools have appeared and have led to great progress in diagnosing the stage of hepatic fibrosis. The aim of this study was to assess the value of real-time tissue elastography, using an instrument made in Japan, for the visible measurement of liver elasticity; in particular, comparing the results with those of transient elastography (Fibroscan).Real-time tissue elastography (RTE), transient elastography (Fibroscan), liver biopsy, and routine laboratory analyses were performed in 101 patients with chronic hepatitis C. The values for tissue elasticity obtained using novel software (Elasto_ver 1.5.1) connected to RTE were transferred to four image features, Mean, Standard Deviation (SD), Area, and Complexity. Their association with the stage of fibrosis at biopsy and with liver stiffness (kPa) obtained by Fibroscan was analyzed.Colored images obtained by RTE were classified into diffuse soft, intermediate, and patchy hard patterns and the calculated elasticity differed significantly between patients according to and correlated with the stages of fibrosis (p < 0.0001). Mean, SD, Area, and Complexity showed significant differences between the stages of fibrosis (Tukey-Kramer test, p < 0.05). In discriminating patients with cirrhosis, the areas under the receiver operating characteristic curves (AUC) were 0.91 for Mean, 0.84 for SD, 0.91 for Area, 0.93 for Complexity, and 0.95 for Fibroscan.RTE is a noninvasive instrument for the colored visualization of liver elasticity in patients with chronic liver disease.