MR elastography outperforms shear wave elastography for the diagnosis of clinically significant portal hypertension.
MR elastography outperforms shear wave elastography for the diagnosis of clinically significant portal hypertension.
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DOI：
10.1007/s00330-022-08935-9
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发表时间：
2022-12
影响因子：
5.9
通讯作者：
Taouli, Bachir
中科院分区：
文献类型：
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作者：
Kennedy, Paul;Stocker, Daniel;Carbonell, Guillermo;Said, Daniela;Bane, Octavia;Hectors, Stefanie;Abboud, Ghadi;Cuevas, Jordan;Bolster, Bradley D., Jr.;Friedman, Scott L.;Lewis, Sara;Schiano, Thomas;Bhattacharya, Dipankar;Fischman, Aaron;Thung, Swan;Taouli, Bachir
门静脉高压症（PH）与并发症（如腹水和食管静脉曲张）相关，通常通过有创肝静脉压力梯度（HVPG）测量进行诊断，但该方法并不广泛。在这项研究中，我们的目的是评估2D/3D MR弹性成像（MRE）和剪切波弹性成像（SWE）测量肝脏和脾脏硬度（LS和SS）和脾脏体积的诊断性能，以无创诊断临床显著的门脉高压症（CSPH）使用HVPG测量作为参考。在这项前瞻性研究中，肝病患者接受了肝脏和脾脏的2D/3D MRE和SWE以及HVPG测量。评估了LS/SS的MRE/SWE测量值和脾脏体积与HVPG之间的相关性。采用ROC曲线分析MRE、SWE和脾脏体积对CSPH的诊断价值。纳入36例患者（男/女22/14，平均年龄55± 14岁）。在评价的参数中，3D MRE SS与HVPG的相关性最强（r=0.686，p<0.001），其次是2D MRE SS（r=0.476，p=0.004）。3D MRE SS显示出诊断CSPH的最佳性能（AUC=0.911），其次是2D MRE SS（AUC=0.845）和3D MRE LS（AUC=0.804）。SWE SS在诊断CSPH方面表现不佳（AUC=0.583），而脾脏体积是一个较好的预测因子（AUC=0.738）。对于CSPH的诊断，3D MRE SS显著上级SWE LS/SS（p≤0.021）。3D MRE测量的SS对CSPH的诊断优于SWE。SS似乎是评估PH严重程度的有用生物标志物。这些结果需要进一步验证。
Portal hypertension (PH) is associated with complications such as ascites and esophageal varices, and is typically diagnosed through invasive hepatic venous pressure gradient (HVPG) measurement, which is not widely available. In this study, we aim to assess the diagnostic performance of 2D/3D MR elastography (MRE) and shear wave elastography (SWE) measures of liver and spleen stiffness (LS and SS) and spleen volume, to noninvasively diagnose clinically significant portal hypertension (CSPH) using HVPG measurement as the reference. In this prospective study, patients with liver disease underwent 2D/3D MRE and SWE of the liver and spleen, as well as HVPG measurement. The correlation between MRE/SWE measures of LS/SS and spleen volume with HVPG was assessed. ROC analysis was used to determine the utility of MRE, SWE and spleen volume for diagnosing CSPH. 36 patients (M/F 22/14, mean age 55±14y) were included. Of the evaluated parameters, 3D MRE SS had the strongest correlation with HVPG (r=0.686, p<0.001), followed by 2D MRE SS (r=0.476, p=0.004). 3D MRE SS displayed the best performance for diagnosis of CSPH (AUC=0.911) followed by 2D MRE SS (AUC=0.845) and 3D MRE LS (AUC=0.804). SWE SS showed poor performance for diagnosis of CSPH (AUC=0.583) while spleen volume was a fair predictor (AUC=0.738). 3D MRE SS was significantly superior to SWE LS/SS (p≤0.021) for diagnosis of CSPH. SS measured with 3D MRE outperforms SWE for the diagnosis of CSPH. SS appears to be a useful biomarker for assessing PH severity. These results need further validation.
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影响因子：
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