Evaluation of Liver Fibrosis and Portal Hypertension in Chronic Hepatitis B Patients by Acoustic Radiation Force Impulse Elastography
Evaluation of Liver Fibrosis and Portal Hypertension in Chronic Hepatitis B Patients by Acoustic Radiation Force Impulse Elastography
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声辐射力脉冲弹性成像评价慢性乙型肝炎患者肝纤维化和门脉高压
DOI：
10.5812/iranjradiol.82396
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发表时间：
2020-01
影响因子：
0.3
通讯作者：
Wen-Ping Wang
中科院分区：
文献类型：
--
作者：
Yu-Li Zhu;Hong Ding;Tian-Tian Fu;Shi-Yao Chen;Jian-Jun Luo;Chen Xu;Yuan Zhuang;Wen-Ping Wang
背景资料：准确评估慢性B型肝炎（CH B）患者的肝纤维化和肝硬化程度对于确定治疗策略、监测和预后至关重要。目的：探讨声辐射力脉冲（ARFI）弹性成像在评估肝纤维化程度及门脉高压肝硬化严重程度中的价值。患者和方法：196例连续CHB患者行部分肝切除术和64例晚期肝硬化患者行肝静脉压力梯度（HVPG）测量，进行了ARFI成像检查。采用Scheuer评分系统和HVPG值分别与肝组织学检查结果进行比较。还进行了脾硬度测量（SSM）和脾指数，并将这些值与HVPG测量值进行比较。结果如下：显著纤维化（S ≥ S2）和肝硬化（S4）诊断的受试者工作特征曲线下面积（AUROC）分别为0.952和0.976，最佳LSM截断点的相应值分别为1.26 m/s和1.58 m/s。64例晚期胃癌患者LSM与HVPG的相关系数为0.637（P < 0.001）。预测HVPG ≥ 10 mm Hg和HVPG ≥ 12 mm Hg的截断值分别为1.79 m/s和1.90 m/s（AUROC：0.665和0.859）。晚期肝硬化组的SSM值和脾脏指数与HVPG均无统计学关系，但两者之间存在显著相关性（ρ = 0.604，P < 0.05）。结论：ARFI成像作为一种无创性的弹性超声检查方法，不仅可用于慢性乙型肝炎患者肝纤维化分期，而且可根据门脉高压程度评估肝硬化的严重程度。
Background: Accurate evaluation of the degree of fibrosis and cirrhosis is crucial for determining treatment strategies, surveillance, and prognosis in patients with chronic hepatitis B (CHB). Objectives: To explore the value of acoustic radiation force impulse (ARFI) elastography in assessing the stage of liver fibrosis and the severity of cirrhosis based on portal hypertension. Patients and Methods: One hundred ninety-six consecutive CHB patients who underwent partial hepatectomy and sixty-four advanced cirrhosis patients who underwent hepatic vein pressure gradient (HVPG) measurement were examined with ARFI imaging. Liver stiffness measurements (LSMs) were obtained and compared with the hepatic histological findings by using Scheuer scoring system and with the value of HVPG, respectively. A spleen stiffness measurement (SSM) and spleen index were also performed, and the values were compared with HVPG measurements. Results: Areas under the receiver operating characteristics curve (AUROCs) were 0.952 and 0.976, respectively for the diagnosis of significant fibrosis (S ≥ S2) and cirrhosis (S4), with the corresponding values of 1.26 m/s and 1.58 m/s for optimal LSM cutoff points. For advanced cirrhotic patients (n = 64), the correlation coefficient between LSM and HVPG was 0.637 (P < 0.001). The cutoff values for predicting HVPG ≥ 10 mm Hg and HVPG ≥ 12 mm Hg were 1.79 m/s and 1.90 m/s, respectively (AUROC: 0.665 and 0.859). Neither the value of SSM nor the spleen index showed a statistical relationship with HVPG in the advanced cirrhosis group, but they were significantly correlated with each other (ρ = 0.604, P < 0.05). Conclusion: As a noninvasive elastosonography for the evaluation of liver stiffness, ARFI imaging could not only be used to stage liver fibrosis in CHB patients, but also to evaluate the severity of cirrhosis based on portal hypertension.
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影响因子：
4.3
作者：
Kircheis, Gerald;Sagir, Abdurrahman;Haeussinger, Dieter
通讯作者：
Haeussinger, Dieter
DOI：
10.1097/01.meg.0000263815.03674.6a
发表时间：
2007-07
影响因子：
2.1
作者：
J. Plevris
通讯作者：
J. Plevris
影响因子：
29.4
作者：
Colecchia, Antonio;Montrone, Lucia;Festi, Davide
通讯作者：
Festi, Davide
DOI：
10.1038/ajg.2012.319
发表时间：
2013
期刊：
The American Journal of Gastroenterology
影响因子：
--
作者：
S. Kane;J. Leighton;C. Kefalas;L. Cohen;P. Katz;Maged Rizk;I. Pike;B. Lashner;I. Ho;M. Pochapin;M. Seabrook;D. Greenwald;Danielle DeMarco;D. Johnson
通讯作者：
S. Kane;J. Leighton;C. Kefalas;L. Cohen;P. Katz;Maged Rizk;I. Pike;B. Lashner;I. Ho;M. Pochapin;M. Seabrook;D. Greenwald;Danielle DeMarco;D. Johnson
影响因子：
13.5
作者：
Suzuki, A;Angulo, P;Lindor, K
通讯作者：
Lindor, K