Rational arrangement of measuring shear wave speed in the liver
Rational arrangement of measuring shear wave speed in the liver
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DOI：
10.3748/wjg.v25.i20.2503
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发表时间：
2019-05
影响因子：
4.3
通讯作者：
Takeshi Yokoo;Tsutomu Kanefuji;T. Suda;Itsuo Nagayama;Takahiro Hoshi;Satoshi Abe;S. Morita;Hiroteru Kamimura;Kenya Kamimura;A. Tsuchiya;M. Takamura;K. Yagi;S. Terai
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文献类型：
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作者：
Takeshi Yokoo;Tsutomu Kanefuji;T. Suda;Itsuo Nagayama;Takahiro Hoshi;Satoshi Abe;S. Morita;Hiroteru Kamimura;Kenya Kamimura;A. Tsuchiya;M. Takamura;K. Yagi;S. Terai
剪切波速度已被广泛应用于量化肝纤维化的程度。然而，没有标准化的程序，这使得很难普遍利用速度。目的为剪切波速度测量提供程序标准化。方法对781例患者进行点剪切波弹性成像（pSWE）检查，对18例患者进行2dSWE检查。在12个研究中心放置感兴趣区域，并计算中位数和稳健变异系数（CVR）。在18种情况下，假设每个测量值为1至12个，计算1000次迭代的自举值的残差平方和（ESDi 2）。基于pSWE和2dSWE之间的相关性，将Δ d12的比例（% Δ d12）计算为Δ d12与pSWE的比率。结果CVR在左叶的分布较宽（P < 0.0001），右眼前段最小，占95%，占40.4%。左叶pSWE显著高于右叶（1.63 ± 0.78 m/s vs 1.61 ± 0.78 m/s，P = 0.0004），当受试者仅限于任何节段CVR小于40.4%的病例时，各叶之间的差异变得更加离散（1.76 ± 0.80）m/s比（1.70 ± 0.82）m/s，P < 0.0001。CVR的最高值在每0.1 m/s的时间间隔内沿着pSWE向上凸起，并在1.93 m/s处达到峰值。pSWE与2dSWE呈显著正相关（P < 0.0001，r = 0.95）。在18例216000个重复样本中，12个位点的% candidi 2为8.0%，并随着采集位点的减少而逐渐增加，7个位点的% candidi 2达到显著差异（P = 0.027）。结论在两个脑叶中，应在8个或8个以上的扩展部位测量剪切波速度。
BACKGROUND Shear wave speed has been widely applied to quantify a degree of liver fibrosis. However, there is no standardized procedure, which makes it difficult to utilize the speed universally. AIM To provide procedural standardization of shear wave speed measurement. METHODS Point shear wave elastography (pSWE) was measured in 781 patients, and two-dimensional shear wave elastography (2dSWE) was measured on the same day in 18 cases. Regions-of-interest were placed at 12 sites, and the median and robust coefficient-of-variation (CVR) were calculated. A residual sum-of-square (Σdi2) was computed for bootstrap values of 1000 iterations in 18 cases with each assumption of 1 to 12 measurements. The proportion of the Σdi2 (%Σdi2) was calculated as the ratio of Σdi2 to pSWE after converting it based on the correlation between pSWE and 2dSWE. RESULTS The CVR showed a significantly broader distribution in the left lobe (P < 0.0001), and the smallest CVR in the right anterior segment that covered 95% cases was 40.4%. pSWE was significantly higher in the left lobe than in the right lobe (1.63 ± 0.78 m/s vs 1.61 ± 0.78 m/s, P = 0.0004), and the difference between the lobes became further discrete when the subjects were limited to the cases with a CVR less than 40.4% in any segment (1.76 ± 0.80 m/s vs 1.70 ± 0.82 m/s, P < 0.0001). The highest values of the CVR in every 0.1 m/s interval were plotted in convex upward along pSWE and peaked at 1.93 m/s. pSWE and 2dSWE were significantly correlated (P < 0.0001, r = 0.95). In 216000 resamples from 18 cases, the %Σdi2 of 12 sites was 8.0% and gradually increased as the acquisition sites decreased to reach a significant difference with a %Σdi2 of 7 sites (P = 0.027). CONCLUSION These data suggest that shear wave speed should be measured at 8 or more sites of spreading in both lobes.