Evaluation of liver fibrosis by transient elastography using acoustic radiation force impulse: comparison with Fibroscan®
Evaluation of liver fibrosis by transient elastography using acoustic radiation force impulse: comparison with Fibroscan®
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DOI：
10.1007/s00535-011-0437-3
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发表时间：
2011-10-01
影响因子：
6.3
通讯作者：
Hibi, Toshifumi
中科院分区：
文献类型：
--
作者：
Ebinuma, Hirotoshi;Saito, Hidetsugu;Hibi, Toshifumi
背景
为确定恰当的治疗方法，需要对慢性肝损伤患者的肝纤维化进行准确评估。多种方法，包括实验室检查和瞬时弹性成像，已被用于评估肝纤维化。近期，结合声辐射力脉冲（ARFI）的瞬时弹性成像技术已被研发出来，并与常规超声检查相结合应用。本研究的目的是评估结合ARFI的瞬时弹性成像的临床应用价值，并将该方法的结果与Fibroscan（R）检测结果进行比较。
方法
本研究前瞻性纳入了131例在我科接受肝活检的肝损伤患者。在肝活检的同时进行结合ARFI的弹性成像（使用ACUSON S2000（R）设备）以及Fibroscan（R）检测。将这些测量结果与肝活检标本的组织学结果进行比较，并通过受试者工作特征分析评估测量的准确性。
结果
两种检测方法的弹性成像值均与肝纤维化分期显著相关，且两种方法所得结果差异不大。ARFI在区分F0期无纤维化和F1期以上纤维化时诊断准确性不足，但该方法足以诊断晚期纤维化。ARFI的准确性几乎与Fibroscan（R）方法相当。此外，当纤维化分期较低时，ARFI和Fibroscan（R）的值均与肝脏炎症的严重程度成正比，但与脂肪变性的严重程度不成正比。
结论
结合ARFI的瞬时弹性成像是一种简单、无创且对诊断慢性肝病纤维化分期有用的方法。ARFI的应用价值几乎与Fibroscan（R）方法相当。
Background Accurate evaluation of liver fibrosis in patients with chronic liver damage is required to determine the appropriate treatment. Various approaches, including laboratory tests and transient elastography, have been used to evaluate liver fibrosis. Recently, transient elastography with acoustic radiation force impulse (ARFI) has been developed and applied with conventional ultrasonography. The aim of this study was to evaluate the clinical utility of transient elastography with ARFI and to compare the results with this method and those of the Fibroscan (R) procedure.Methods One hundred and thirty-one patients with liver damage, who underwent liver biopsy at our department, were enrolled prospectively in this study. Elastography with ARFI (applied with ACUSON S2000 (R)), and Fibroscan (R) was performed at the same time as liver biopsy. These measurements were compared with histological findings in liver biopsy specimens, and measurement accuracy was evaluated by receiver-operating characteristic analysis.Results Elastography values with both procedures were significantly correlated with the stages of liver fibrosis and there was little difference in the results obtained using the 2 procedures. The accuracy of differential diagnosis between no fibrosis at F0 and more than F1 stage was insufficient with ARFI, but this procedure was sufficient for diagnosing advanced fibrosis. The accuracy of ARFI was almost equivalent to that of the Fibroscan (R) method. Moreover, both ARFI and Fibroscan (R) values increased in proportion to the severity of hepatic inflammation when fibrosis stage is low, but not in proportion to the severity of steatosis.Conclusions Transient elastography with ARFI is simple, non-invasive and useful for diagnosing the stage of fibrosis in chronic liver disease. The utility of ARFI was almost equivalent to that of the Fibroscan (R) method.